Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Eval Clin Pract. 2013 Aug;19(4):626-32. doi: 10.1111/j.1365-2753.2012.01873.x. Epub 2012 Jul 18.
The objective of this study was to assess the quality of clinical practice guidelines providing diagnostic recommendations on pheochromocytoma (PHEO) using the new Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument and to promote the development of clinical guidelines.
We searched MEDLINE and electronic databases for guidelines published between 2001 and 2010 regarding the diagnosis of PHEO. The methodological quality of guidelines for three fields for the diagnosis of PHEO was evaluated using the new AGREE II instrument by two independent appraisers. We also compared two different types of guidelines to determine the superior guideline.
Four special guidelines and six general guidelines related to the diagnosis of PHEO were included in the study. According to AGREE II, two guidelines performed well in recommending biochemical evaluations. One guideline was good for radiodiagnosis, but no guideline was good for recommending genetic testing. The best-performing domain of the AGREE II instrument was domain 1 (D1) (scope and purpose), while the worst performing domain was D5 (applicability) in both types of guidelines. The special guideline was significantly better than the general guideline in D4 (P < 0.01), while the general guideline performed better in D6. There were no differences in the other four domains.
The quality and rigour of guidelines for the diagnosis of PHEO vary. It is difficult to identify one guideline that performed well in all three fields for the diagnosis of PHEO based on the AGREE II instrument. Therefore, additional studies and greater efforts should be taken to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision making in diagnosing PHEO according to the AGREE II instrument.
本研究旨在使用新的评估指南研究与评价（AGREE II）工具评估提供嗜铬细胞瘤（PHEO）诊断建议的临床实践指南的质量，并促进临床指南的发展。
我们搜索了 MEDLINE 和电子数据库，以获取 2001 年至 2010 年间发表的关于 PHEO 诊断的指南。两名独立评估者使用新的 AGREE II 工具评估了 PHEO 诊断的三个领域的指南的方法学质量。我们还比较了两种不同类型的指南，以确定哪种指南更优。
本研究纳入了 4 项专门指南和 6 项一般指南。根据 AGREE II，有两项指南在推荐生化评估方面表现良好。一项指南在放射诊断方面表现良好，但没有指南在推荐基因检测方面表现良好。AGREE II 仪器表现最好的领域是领域 1（D1）（范围和目的），而在两种类型的指南中表现最差的领域是领域 5（适用性）。专门指南在 D4 方面明显优于一般指南（P < 0.01），而一般指南在 D6 方面表现更好。其他四个领域没有差异。
PHEO 诊断指南的质量和严谨性各不相同。根据 AGREE II 仪器，很难确定一种在 PHEO 诊断的所有三个领域都表现良好的指南。因此，应该开展更多的研究和努力，根据 AGREE II 仪器提供高质量的指南，作为诊断 PHEO 的临床决策的有用和可靠工具。
