指南临床适用性评价工具(2.0版)

Establishment of the instrument for evaluating clinical applicability of guidelines(version 2.0)

目的更新完善本团队前期建立的指南临床适用性评价工具(1.0版)。方法通过更新现有指南临床适用性评价工具的系统评价形成指南临床适用性评价工具(2.0版)初始条目清单,开展德尔菲专家咨询,综合专家意见建立指南临床适用性评价工具(2.0版)。结果2.0版工具中评价者基本信息、评价条目的大体结构和覆盖领域与1.0版一致,包含评价条目12条,覆盖可获得性、可读性、可接受性、可行性和总体评价5个领域。但2.0版工具在1.0版工具基础上新增可行性领域下部分选项,包括:“指南未提供配套工具或支持资源,操作性不强”、“指南未能达到预期诊疗效果”、“您所在医疗机构的医务人员认为不需要指南指导,例如诊疗经验足够”,“指南制订组织机构和人员缺乏权威性”和“您所在医疗机构的医务人员不愿改变原诊疗习惯”。结论2.0版工具较1.0版工具评价内容更完善,将更好地评价指南的临床适用性,促进指南的临床应用。

Objective To update and form an instrument for evaluating clinical applicability of guidelines(version 1.0).Methods We updated the systematic review of global guideline clinical applicability evaluation instruments to form the initial item list and carried out Delphi expert consultation to establish the instrument for evaluating clinical applicability of guidelines(version 2.0).Results The general structure of version 2.0 was consistent with that of version 1.0,which included 12 evaluation items belonging to five domains covering accessibility,readability,acceptability,feasibility,and an overall evaluation.Moreover,some new items were added in version 2.0,such as"The guideline does not provide supporting tools or resources and the operation is poor","After the guideline implementation,the expected effects of diagnosis and treatment do not be achieved","Medical staff in your workplace believe that the guideline is not necessary because they have sufficient medical experience,etc.","Lack of authority of the organizations and personnel that developed the guideline"and"Medical staff in your workplace are reluctant to change the original medical practice".Conclusion This study updated and formed an instrument for evaluating clinical applicability of guidelines(version 2.0),which is able to better assess the applicability of new clinical guidelines and greatly promote more appropriate guidelines into practice.