Group of Investigative Dermatology (GRID), School of Medicine, University of Antioquia, Carrera 20 # 2 Sur 185, Cons 1002 Clinica El Rosario, El Tesoro, Medellín, Colombia,
Arch Dermatol Res. 2014 Apr;306(3):269-77. doi: 10.1007/s00403-013-1394-x. Epub 2013 Aug 8.
A significant number of clinical practice guidelines (CPGs) about the treatment of acne vulgaris in adolescents and adults have been published worldwide. However, little is known about the quality of CPGs in this field. The aim of this study was to appraise the methodological quality of published acne vulgaris CPGs. We performed a systematic review of published CPGs on acne vulgaris therapy from July 2002 to July 2012. Three reviewers independently assessed each CPG using the AGREE II instrument. A standardized score was calculated for each of the six domains. Our search strategy identified 103 citations but just six met our inclusion criteria. Agreement among reviewers was very good: 0.981. The domains that scored better were: "scope and purpose" and "clarity and presentation". Those that scored worse were "stakeholder involvement", "rigor of development", and "applicability". The European and the Malaysian CPGs were the only recommended with no further modifications. In addition, the Mexican, Colombian and the United States guidelines were recommended with provisos, with lower scores regarding stakeholder involvement, rigor of development and applicability. Only two guidelines clearly reported outcome measures for evaluating efficacy or included quality of life outcomes. CPGs varied regarding the consideration of light/laser therapy or consideration of complementary/alternative medicines. None of them included cost considerations of drugs such as systemic isotretinoin. In conclusion, published acne vulgaris CPGs for acne therapy vary in quality with a clear need to improve their methodological rigor. This could be achieved with the adherence to current CPGs development standards.
已有大量关于青少年和成人寻常痤疮治疗的临床实践指南（CPG）在全球范围内发布。然而，对于该领域 CPG 的质量知之甚少。本研究旨在评估已发表的寻常痤疮 CPG 的方法学质量。我们对 2002 年 7 月至 2012 年 7 月发表的寻常痤疮治疗 CPG 进行了系统评价。三位评审员使用 AGREE II 工具独立评估了每个 CPG。为每个六个领域计算了标准化得分。我们的搜索策略确定了 103 条引文，但只有 6 条符合纳入标准。评审员之间的一致性非常好：0.981。评分较高的领域为：“范围和目的”和“清晰度和呈现”。评分较低的是“利益相关者参与”、“开发严谨性”和“适用性”。只有欧洲和马来西亚的 CPG 被推荐，无需进一步修改。此外，墨西哥、哥伦比亚和美国的指南也被推荐，但有条件，在利益相关者参与、开发严谨性和适用性方面得分较低。只有两份指南明确报告了评估疗效的结果衡量标准，或纳入了生活质量结果。CPG 对光/激光治疗的考虑或对补充/替代药物的考虑存在差异。它们都没有包括系统异维 A 酸等药物的成本考虑。总之，已发表的寻常痤疮治疗 CPG 在质量上存在差异，明确需要提高其方法学严谨性。这可以通过遵守当前的 CPG 开发标准来实现。
