基于AGREE-China的健康儿童补充钙和维生素D指南与共识的质量评价

Guidelines and Consensus on Calcium and Vitamin D Supplementation in Healthy Children:a Quality Evaluation Study Based on AGREE-China

目的:评价国内外健康儿童补充钙/维生素D(VD)的指南与共识的方法学质量。方法:系统检索PubMed、Embase、CNKI、WanFang Data、SinoMed数据库,并检索指南数据库及相关学会网站,搜集国内外发表的健康儿童补钙/VD的指南与共识,检索时限均为从建库至2021年4月7日。由2名研究者按照纳入与排除标准独立完成文献筛选、资料提取,采用AGREE-China对纳入指南和共识进行方法学质量评价,以ICC值评估结果一致性。结果:共纳入18篇指南与共识,分别来自中国、美国、加拿大、法国、澳大利亚、新西兰、欧洲等国家或地区,发表年度从2007~2021年。AGREE-China的5个领域平均得分分别为:科学性/严谨性18.49%,有效性/安全性51.84%,经济性33.16%,可用性/可行性56.67%,利益冲突71.58%。纳入指南与共识的方法学质量整体较低,其中5篇指南与共识为不推荐,其余均为弱推荐。结论:目前全球范围内,健康儿童补钙/VD的指南与共识的方法学质量整体较低。我国补钙/VD指南与共识的整体质量均较低,亟需整合当前最佳证据,制订符合我国国情的健康儿童补钙/VD的高质量循证指南。

Objective:To evaluate the methodological quality of guidelines and consensus on calcium or vitamin D(VD) supplementation in healthy children.Methods:PubMed,Embase,CNKI,WanFang Data,SinoMed database,guideline databases,and related associations websites were systematically searched to collect guidelines and consensus on calcium or VD supplementation in healthy children from the inception to April 7 th,2021.Two researchers independently completed literature screening and data extraction according to the inclusion and exclusion criteria,and evaluated the methodological quality of the guidelines and consensus by AGREE-China,and the ICC value was used to assess the consistency of the results.Results:A total of 18 guidelines and consensuses were included,from China,the United States,Canada,France,Australia,New Zealand,Europe,and other countries or regions.The overall publication year was from 2007 to 2021.The average scores for each domain of AGREE-China were 18.49% for scientificity/rigorism,51.84% for effectiveness/safety,33.16% for the economy,56.67% for usability/feasibility,and 71.58% for conflict of interest.The overall quality of the included guidelines and consensus was low,5 guidelines and consensus were recognized as not recommended,while the rest were weakly recommended.Conclusion:At present,the methodological quality of included worldwide guidelines and consensus for calcium or VD supplementation in healthy children is generally low,and Chinese guidelines and consensus are of low quality.Therefore,it is urgent to integrate the current best evidence and formulate high-quality evidence-based guidelines for healthy children’s calcium supplementation/VD in line with Chinese conditions.