机器人手术指南与专家共识的方法学质量评价

Methodological quality assessment of robot-assisted surgery guidelines and consensus

目的分析评价机器人手术临床应用相关指南或专家共识的方法学质量。方法计算机检索国内外指南网站及电子数据库中关于机器人手术临床应用的指南或专家共识,检索时限为2000年1月1日—2021年12月29日,按照纳入和排除标准进行筛选。2名评价人员采用AGREEⅡ(Appraisal of Guidelines for Research and EvaluationⅡ)工具对指南和专家共识独立进行评价,对2名研究人员的组内相关系数进行一致性检验,并计算指南和专家共识在AGREEⅡ6个领域的得分。结果共纳入34篇文献,其中指南10篇,专家共识24篇。2名研究人员的一致性较好,组内相关系数>0.75。纳入指南和专家共识在AGREEⅡ6个领域(范围和目的、参与人员、制定的严谨性、表达的清晰性、应用性和编辑的独立性)的平均得分分别为81.0%、43.5%、28.2%、81.5%、12.7%和51.7%。结论目前国内外的机器人手术指南在制定的严谨性、应用性和编辑独立性等方面仍有待提高。随着机器人手术的不断开展,建议制定证据等级更高的循证指南和专家共识,以促进机器人手术的规范化应用。

Objective To evaluate the methodological quality of clinical practice guidelines and consensuses of robot-assisted surgery.Methods The guidelines and consensuses were screened according to the inclusion and exclusion criteria by searching the domestic and overseas guidelines network and electronic database from 1 January,2000 to 29 December,2021.The Appraisal of Guidelines for Research and EvaluationⅡ(AGREEⅡ)instrument was used independently by two evaluators to evaluate the guidelines and consensuses.The consistency test of intraclass correlation coefficient(ICC)was carried out for two evaluators,and the score of guidelines and consensuses in the six domains of AGREEⅡwere calculated.Results A total of 34 guidelines and consensuses were included,including 10 guidelines and 24 consensuses.The ICC was all greater than 0.75,indicating that the consistency of the two evaluators was high.The average scores of the 34 guidelines and consensuses in the six domains of AGREEⅡ(scope and purpose,stakeholder involvement,rigor of development,clarity of presentation,applicability and editorial independence)were 81.0%,43.5%,28.2%,81.5%,12.7%and 51.7%,respectively.Conclusion These evaluated guidelines and consensuses of robot-assisted surgery still need to be improved in the domains of rigor of development,applicability and editorial independence.With the continuous development of robot-assisted surgery,more guidelines and consensuses based on higher level of evidence will be developed to promote the standardized use of robot-assisted surgery.