WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
J Affect Disord. 2015 Mar 15;174:45-50. doi: 10.1016/j.jad.2014.11.032. Epub 2014 Nov 25.
There is an increasing concern about the quality of clinical practice guidelines. Because no information is available on the rigour of development of clinical practice guidelines for bipolar disorder, we carried out a systematic review of those focusing on its pharmacological treatment.
We searched the National Guideline Clearinghouse, MEDLINE, EMBASE, PsychINFO and CINHAL for guidelines published from 2003 to 2014. The quality of each guideline was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II).
Fourteen guidelines were appraised. The overall quality of included guidelines varied considerably, both within and across AGREE II domains. Overall, six guidelines were rated as "recommended", two "recommended with modifications", and six were not recommended according to AGREE II ratings. The mean score for rigour of development was 46.8% of the maximum possible score, with no guidelines scoring the maximum score in this domain. Guidelines with lower editorial independence scores also had lower rigour of development scores, whereas those with higher-quality domain scores scored high in both domains.
As current appraisal focused on guidelines for the pharmacological treatment of bipolar disorder, it will be important to critically assess the rigour of development of other guidelines for bipolar and other psychiatric disorders.
Health care providers, policy makers, physicians and patients alike need to be aware of the variability in guideline quality and identify the high-quality guidelines that meet their needs.
人们越来越关注临床实践指南的质量。由于目前尚无关于双相障碍临床实践指南制定严谨性的信息，我们对专注于其药物治疗的指南进行了系统评价。
我们在 2003 年至 2014 年间从国家指南清理中心、MEDLINE、EMBASE、PsychINFO 和 CINHAL 中搜索发布的指南。使用评估研究和评估指南 II（AGREE II）评估每个指南的质量。
评估了 14 条指南。纳入指南的总体质量差异很大，无论是在 AGREE II 域内还是跨域内。总体而言，有 6 条指南被评为“推荐”，2 条“推荐但需修改”，6 条根据 AGREE II 评分不推荐。发展严谨性的平均得分为最高可能分数的 46.8%，没有指南在该领域获得满分。编辑独立性评分较低的指南其发展严谨性评分也较低，而那些在其他领域评分较高的指南在这两个领域的评分都较高。
由于当前的评估侧重于双相障碍药物治疗指南，因此重要的是要批判性地评估其他双相和其他精神障碍指南的制定严谨性。
医疗保健提供者、政策制定者、医生和患者都需要意识到指南质量的可变性，并确定符合其需求的高质量指南。
