摘要
目的循证评价儿童毛细支气管炎临床指南,比较推荐意见的异同,为临床使用提供参考。方法计算机检索Pub Med、EMbase、CNKI、VIP、Wan Fang Data、CBM数据库以及医脉通(Medlive)、GIN(Guidelines International Network)、CGC(China Guideline Chearinghouse)、NGC(National Guideline Clearinghouse)、AAP(American Academy of Pediatrics)、NICE(National Institute for Health and Clinical Excellence)和WHO(World Health Organization)网站,纳入毛细支气管炎相关临床指南,检索时限均为建库至2015年12月,使用AGREEⅡ工具评价纳入指南的质量,分析比较各指南推荐意见的异同。结果最终纳入指南8篇,其中5篇循证指南,3篇非循证指南。AGREEⅡ系统评价6大领域得分最高为"清晰性"(81%),其次为"范围与目的"(74%)、"参与人员"(56%)、"应用性"(52%)、"编辑独立性"(43%),最低为"严谨性"(42%)。不同指南的推荐意见基本一致,但个别建议间略有差异。结论目前儿童毛细支气管炎指南中得分较高的领域是"清晰性"和"范围与目的",而"参与人员"、"应用性"、"编辑独立性"和"严谨性"领域需要加强。当前我国仅有毛细支气管炎专家共识,且质量有待进一步提高。应尽快制定符合我国国情的儿童毛细支气管炎循证指南,为循证临床实践提供更好的指导和药物使用。
Objective To systematically review the methodological quality of guidelines on the management of bronchiolitis in children, then to compare the recommendations and to provide a reference for clinical use. Methods Guidelines concerning bronchiolitis were electronically retrieved in CNKI, VIP, Wan Fang Data, CBM, Pub Med, EMbase, Medlive, GIN（Guidelines International Network）, CGC（China Guideline Chearinghouse）, NGC（National Guideline Clearinghouse）, AAP（American Academy of Pediatrics）, NICE（National Institute for Health and Clinical Excellence） and WHO（World Health Organization） from inception to December 2015. The methodological quality of included guidelines were evaluated according to the AGREE II instrument, and the differences between recommendations were compared. Results Eight guidelines on bronchiolitis were included, Among them, one guideline was developed by UK, two by US, one by Spain, two by Australia, one by Scottish and one by South Africa. Five of them were evidence-based（EB） guidelines, and 3 were non-EB guidelines. Domain 4（clarity of presentation） showed the highest scores（ 81 %）, then scope and purpose（ 74 %）, stakeholder involvement（ 56 %）, rigor of development（ 52 %）, editorial independence（ 43 %）, and scores（ 42 %） were the lowest in domain 3（applicability）. The recommendations of managements and medicines for bronchiolitis were basically consistent, but there were individual differences suggested. Conclusion In these guidelines, the domain score better is ＂clarity of presentation＂ and ＂scope and purpose ＂, but the other areas should need to improve. Current our country only has an expert consensus of bronchiolitis, which should be further improved. It＇s urgent to develop evidence-based guidelines which conforms to the situation of our country, in order to make evidence-based medicine implementation in clinical practice.
出处
《中国循证医学杂志》
CSCD
2016年第10期1207-1215,共9页
Chinese Journal of Evidence-based Medicine
基金
河北省卫生厅医学科学研究课题计划(编号:20150567)
