心力衰竭临床指南评价

Evaluation of clinical guidelines for heart failure

目的使用AGREEⅡ评价工具对国内外心力衰竭(HF)相关临床实践指南进行质量评价,为我国制定心衰相关指南提供理论支持。方法检索中国知网(CNKI)、PubMed、Embase、Web of science数据库;国际指南网(GIN)、苏格兰学院间指南网络(SIGN)、英国国家卫生与临床评价机构(NICE)、中国医脉通等指南网站,纳入公开发表的心衰相关临床实践指南,并利用EXCEL 2013对收录指南的名称、发布机构、发布年份、制定方法、类型、页数等一般信息进行提取和分析。使用AGREEⅡ评估指南的质量。结果共纳入30部指南,国内8部、国外22部,中文7部、英文23部,纳入指南总体质量一般,AGREEⅡ6个领域中平均得分由高到低依次是清晰性(78.26%)、范围和目的(53.93%)、严谨性(35.06%)、独立性(33.33%)、应用性(30.17%)及参与人员(27.01%)。指南总体质量评价结果为:3部“强推荐”、23部“修订后推荐”及4部“不推荐”。结论目前现有的30部心衰相关临床实践指南质量一般;指南的严谨性,独立性,应用性,参与人员有待提高。国内8部指南中6部整体评价为“修订后推荐”,2部整体评价为“不推荐”,指南总体质量相对较差,可借鉴国外的高质量指南制定方法,结合本地实际情况,制定契合我国的高质量HF指南。

Objective Accessing the quality of clinical practice guidelines related to heart failure(HF)in China and abroad using AGREEⅡis to provide theoretical support for developing HF-related guidelines in China.Methods Search CNKI,PubMed,EMBASE,web of science database,guidelines international network(GIN),Scottish Intercollegiate Guidelines Network(SIGN),National Institute for Health and Clinical Excellence(NICE)and other guide websites,Include the published HF-related clinical practice guidelines,and use Excel 2013 to extract and analyze the general information such as the name,release the organization,release year,formulation method,type and number of pages of the included guidelines.Use AGREE II to assess the quality of the guidelines.Results 30 guidelines were included,including 8 in China,22 abroad,7 in Chinese,and 23 in English.The overall quality of the included guideline was moderate.The average score for the 6 AGREEⅡareas,from highest to lowest,is clarity(78.26%),scope and purpose(53.93%),conscientiousness(35.06%),independence(33.33%),applicability(30.17%),and participants(27.01%).The overall quality evaluation results of the guide are 3“strongly recommended”,23“revised recommended”and 4“not recommended”.Conclusions The existing 30 HF-related clinical practice guidelines are of average quality;the preciseness,independence,application,and participants'guidelines need to be improved.Among the 8 domestic guidelines,6 were evaluated as“revised recommended”and 2 as“not recommended”.The overall quality of the guidelines is relatively poor,so local practice can be carried out by referring to foreign high-quality guidelines,and evidence suitable for HF patients in China can be mined to help formulate corresponding HF clinical practice guidelines in China.