中国儿童临床指南现状分析及循证临床指南质量评价

Analysis on status of clinical guidelines and evaluation of evidence-based clinical guidelines for children in China

目的分析2010~2021年中国儿童临床指南现状,评价儿童循证临床指南的方法学质量。方法计算机检索PubMed、EMbase、WanFang Data、CNKI、VIP数据库及国内外相关指南库,搜集中国儿童临床指南,检索时限均从2010年1月1日至2021年9月13日。由2名研究者独立筛选文献、提取资料,4名研究者运用AGREEⅡ工具对纳入的循证指南进行质量评价。结果共纳入指南164部,其中循证指南65部,非循证指南99部;西医指南113部,中医指南51部。中国儿童指南覆盖大部分住院负担高的疾病,其中呼吸系统疾病的儿童临床指南居首位(35部),但迄今尚无儿童循环系统疾病的临床指南。65部循证指南质量评价结果显示,AGREEⅡ的6个领域的平均得分为65.2%、49.6%、59.3%、68.5%、23.9%和83.6%。结论我国儿童临床指南在应用性、参与人员和严谨性领域的评分较低,缺乏循环系统疾病的儿童临床指南。

Objective To analyze the current status of children’s clinical practice guidelines from 2010 to 2021,and to evaluate the quality of evidence-based guidelines for children.Methods PubMed,EMbase,CNKI,WanFang Data,and VIP databases and relevant domestic and foreign guideline websites were searched to collect Chinese pediatric clinical guidelines from January 1^(st) 2010 to September 13^(th) 2021.Two reviewers independently screened literature,extracted data;4 reviewers used AGREEⅡ to evaluate the quality of the included evidence-based guidelines.Results A total of 164 guidelines were included,which involved 65 evidence-based guidelines and 99 non-evidence-based guidelines,113 western medicine guidelines and 51 traditional Chinese medicine guidelines.The majority of the diseases with high hospitalization burden were covered by those guidelines,including 35 guidelines for respiratory diseases,ranking first among all diseases.However,there was no guideline for pediatric cardiovascular disease in China.The average scores for 65 evidence-based guidelines in 6 individual domains were 65.2%,49.6%,59.3%,68.5%,23.9% and 83.6%.Conclusions The scores for applicability,stakeholder involvement,and rigor of development are low for Chinese guideline for children.There is a lack of pediatric clinical guidelines for circulatory disorders.