Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau-IIB Sant Pau, Barcelona, Spain.
Implement Sci. 2012 Nov 19;7:109. doi: 10.1186/1748-5908-7-109.
Scientific knowledge is in constant change. The flow of new information requires a frequent re-evaluation of the available research results. Clinical practice guidelines (CPGs) are not exempted from this phenomenon and need to be kept updated to maintain the validity of their recommendations. The objective of our review is to systematically identify, describe and assess strategies for monitoring and updating CPGs.
We conducted a systematic review of studies evaluating one or more methods of updating (with or without monitoring) CPGs or recommendations. We searched MEDLINE (PubMed) and The Cochrane Methodology Register (The Cochrane Library) from 1966 to June 2012. Additionally, we hand-searched reference lists of the included studies and the Guidelines International Network book of abstracts. If necessary, we contacted study authors to obtain additional information.
We included a total of eight studies. Four evaluated if CPGs were out of date, three updated CPGs, and one continuously monitored and updated CPGs. The most detailed reported phase of the process was the identification of new evidence. As opposed to studies updating guidelines, studies evaluating if CPGs were out of date applied restricted searches. Only one study compared a restricted versus an exhaustive search suggesting that a restricted search is sufficient to assess recommendations' Validity. One study analyzed the survival time of CPGs and suggested that these should be reassessed every three years.
There is limited evidence about the optimal strategies for monitoring and updating clinical practice guidelines. A restricted search is likely to be sufficient to monitor new evidence and assess the need to update, however, more information is needed about the timing and type of search. Only the exhaustive search strategy has been assessed for the update of CPGs. The development and evaluation of more efficient strategies is needed to improve the timeliness and reduce the burden of maintaining the validity of CPGs.
科学知识在不断变化。新信息的流动要求对现有研究结果进行频繁的重新评估。临床实践指南（CPGs）也不例外，需要不断更新以保持其建议的有效性。我们的综述目的是系统地识别、描述和评估监测和更新 CPG 的策略。
我们对评估一种或多种更新（有或没有监测）CPG 或建议的方法的研究进行了系统综述。我们从 1966 年至 2012 年 6 月在 MEDLINE（PubMed）和 Cochrane 方法学登记册（Cochrane 图书馆）中进行了搜索。此外，我们还对手头的研究参考文献列表和指南国际网络的摘要手册进行了手工搜索。如有必要，我们联系了研究作者以获取更多信息。
我们共纳入了 8 项研究。其中 4 项研究评估了 CPG 是否过时，3 项更新了 CPG，1 项持续监测和更新了 CPG。报告过程中最详细的阶段是新证据的识别。与更新指南的研究相比，评估 CPG 是否过时的研究应用了限制搜索。只有一项研究比较了限制搜索和全面搜索，表明限制搜索足以评估建议的有效性。一项研究分析了 CPG 的生存时间，并建议每三年重新评估一次。
关于监测和更新临床实践指南的最佳策略的证据有限。限制搜索可能足以监测新证据并评估更新的必要性，但是，需要更多关于搜索的时间和类型的信息。仅评估了全面搜索策略是否可用于更新 CPG。需要开发和评估更有效的策略，以提高及时性并减轻维护 CPG 有效性的负担。
Zotero 插件