基于AGREEⅡ的儿童癫痫药物治疗指南质量评价

Quality Evaluation of Treatment Guidelines for Pediatric Epilepsy Based on Appraisal of Guidelines for Research and EvaluationⅡ

目的:探讨国内外儿童癫痫治疗相关指南的现状并进行质量评价,为优化临床实践指南提供参考。方法:检索PubMed、MedLine、EMBase、中国知网、万方等数据库和相关网站,纳入儿童癫痫治疗相关指南,采用AGREEⅡ工具进行方法学质量评价。评价内容包括范围和目的、参与人员、制定的严谨性、表达的清晰性、应用性及独立性,并对推荐主要内容进行比较分析。结果:多数指南提及了不同癫痫发作类型及儿童癫痫综合征的一、二线用药及添加治疗,各指南的推荐内容略有不同。经评价,美国癫痫协会、英国国家卫生与临床优化研究所、苏格兰校际指南网、国际抗癫痫联盟、美国神经病学学会的指南质量较高,属于强推荐。结论:儿童癫痫药物治疗指南整体质量较高,但仍需进一步优化。

Objective:To probe into the current status and quality evaluation of the treatment guidelines for pediatric epilepsy at home and abroad,so as to provide reference for optimizing clinical guidelines.Methods:PubMed,MedLine,EMBase,CNKI,Wanfang and other databases were retrieved to collect treatment guidelines of pediatric epilepsy.Methodological quality of guidelines was evaluated according to the appraisal of guidelines for research and evaluationⅡ(AGREEⅡ).The evaluation system included scope and purpose,stakeholders’involvement,rigor of development,clarity of presentation,applicability and independence.The main recommended contents were compared and analyzed.Results:Most guidelines referred to first-line and second-line medications and add-on treatments for different epilepsy types and pediatric epilepsy syndromes.The guidelines of the American Epilepsy Society,National Institute for Health and Clinical Excellence,Scottish Interuniversity Guideline Network,International League Against Epilepsy,and American Academy of Neurology were of high quality and strongly recommended.Conclusion:The quality of included guidelines is relatively high,yet further optimization is needed.