Cates J R, Young D N, Guerriero D J, Jahn W T, Armine J P, Korbett A B, Bowerman D S, Porter R C, Sandman T D, King R A
J Manipulative Physiol Ther. 2001 Mar-Apr;24(3):170-6.
To review and identify established methods for evaluating the quality of practice guidelines and to use a selected assessment tool to assess 2 chiropractic practice guideline documents.
A search of the medical literature was performed to identify current methods and procedures for practice guideline evaluation. Two chiropractic practice guideline documents, Vertebral Subluxation in Chiropractic Practice (CCP) and Guidelines for Chiropractic Quality Assurance and Practice Parameters (Mercy) were then independently evaluated for validity by 10 appraisers using the identified appraisal tool. The appraisal scores were tabulated, and consensus appraisals were generated for the CCP and Mercy guideline documents.
The "Appraisal Instrument for Clinical Guidelines" (Cluzeau instrument) was identified as a reliable and valid method of guideline evaluation. The result of the application of this appraisal tool in the assessment of the CCP and Mercy guideline documents was that the former scored notably lower than the latter. On the basis of the results of the guideline appraisals, the CCP document is not recommended, and its guidelines are not considered suitable for application in chiropractic practice. The Mercy guidelines are recommended for application in chiropractic practice, with the proviso that new scientific data should be considered.
The literature reviewed suggests that professional organizations or groups should undertake a critical review of guidelines using available critical guideline appraisal tools. Guideline validity appraisal should be done before acceptance by the chiropractic profession. To avoid unwarranted utilization of poorly constructed guidelines, it is strongly recommended that all future guidelines be reviewed for validity and scientific accuracy with the findings published in a medically indexed journal before they are adopted by the chiropractic community.
回顾并确定评估实践指南质量的既定方法，并使用选定的评估工具评估两份脊椎按摩疗法实践指南文件。
检索医学文献以确定实践指南评估的当前方法和程序。然后，10名评估人员使用所确定的评估工具，对两份脊椎按摩疗法实践指南文件《脊椎按摩疗法实践中的脊椎半脱位》（CCP）和《脊椎按摩疗法质量保证与实践参数指南》（Mercy）进行独立的有效性评估。将评估分数制成表格，并针对CCP和Mercy指南文件生成共识评估。
“临床指南评估工具”（Cluzeau工具）被确定为一种可靠且有效的指南评估方法。该评估工具在评估CCP和Mercy指南文件中的应用结果是，前者的得分明显低于后者。根据指南评估结果，不推荐CCP文件，其指南也不被认为适用于脊椎按摩疗法实践。Mercy指南推荐用于脊椎按摩疗法实践，但前提是应考虑新的科学数据。
所回顾的文献表明，专业组织或团体应使用现有的严格指南评估工具对指南进行严格审查。指南有效性评估应在脊椎按摩疗法专业接受之前进行。为避免不合理地使用构建不佳的指南，强烈建议在脊椎按摩疗法界采用所有未来的指南之前，对其有效性和科学准确性进行审查，并将结果发表在医学索引期刊上。
