Malheiro Rui, de Monteiro-Soares Matilde, Hassan Cesare, Dinis-Ribeiro Mário
CINTESIS/CIDES - Health Information and Decision Sciences Department, Oporto Faculty of Medicine, Oporto, Portugal.
Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy.
Endoscopy. 2014 Jun;46(6):513-25. doi: 10.1055/s-0034-1365394. Epub 2014 Apr 23.
Clinical guidelines are a common feature in modern endoscopy practice and they are being produced faster than ever. However, their methodological quality is rarely assessed. This study evaluated the methodological quality of current clinical guidelines in the field of gastroenterology, with an emphasis on endoscopy.
Practice guidelines published by the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) were searched between September and October 2012 and evaluated using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (23 items, scores 1 - 7 for each item; higher scores mean better quality).
A total of 100 guidelines were assessed. The mean number of items scoring 6 or 7 per guideline was 9.2 (out of 23 items). Overall, 99 % of guidelines failed to include the target population in the development process, and 96 % did not report facilitators and barriers to guideline application. In addition, 86 % did not include advice or tools, and 94 % did not present monitoring or auditing criteria.
The global methodological quality of clinical guidelines in the field of gastroenterology is poor, particularly regarding involvement of the target population in the development of guidelines and in the provision of clear suggestions to practitioners.
临床指南是现代内镜诊疗实践中的常见内容，其发布速度比以往任何时候都快。然而，它们的方法学质量很少得到评估。本研究评估了胃肠病学领域当前临床指南的方法学质量，重点是内镜检查。
检索了美国胃肠病学会（ACG）、美国胃肠病协会（AGA）、美国胃肠内镜学会（ASGE）、欧洲胃肠内镜学会（ESGE）、英国胃肠病学会（BSG）、英国国家卫生与临床优化研究所（NICE）以及苏格兰跨学院指南网络（SIGN）在2012年9月至10月期间发布的实践指南，并使用AGREE II（研究与评估指南评估）工具进行评估（共23项，每项评分1 - 7分；分数越高质量越好）。
共评估了100项指南。每项指南中得分为6分或7分的项目平均数量为9.2项（满分23项）。总体而言，99%的指南在制定过程中未纳入目标人群，96%未报告指南应用的促进因素和障碍。此外，86%未包括建议或工具，94%未给出监测或审核标准。
胃肠病学领域临床指南的全球方法学质量较差，尤其是在目标人群参与指南制定以及为从业者提供明确建议方面。
