Jiang Yanming, Zhu Xiao-Dong, Qu Song, Li Ling, Zhou Zhirui
Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, No. 71 Hedi Rd., Qingxiu District, Nanning 530021, PRC.
Ear Nose Throat J. 2015 Apr-May;94(4-5):E14-24.
We conducted a study to evaluate the quality of guidelines for squamous cell carcinoma of the head and neck (SCCHN) with the exception of nasopharyngeal cancer. Electronic searches were conducted of the U.S. National Guideline Clearinghouse, the Canadian Medical Association Infobase, the Guidelines International Network, the Scottish Intercollegiate Guidelines Network, the China Biology Medicine disc, PubMed, and Embase. Two independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The degree of agreement among these sources was evaluated by using the intraclass correlation coefficient (ICC). A total of 514 articles were found to be clinical-guideline-related, and 49 guidelines were included in our analysis. Scores were assigned for each of the AGREE II domains: scope and purpose (mean: 71.63% ± 2.80; median: 75%; ICC: 0.76), stakeholder involvement (mean: 43.37% ± 2.96; median: 50%; ICC: 0.93), rigor of development (mean: 45.63% ± 3.84; median: 42%; ICC: 0.83), clarity of presentation (mean: 68.08% ± 2.53; median: 72%; ICC: 0.85), applicability (mean: 32.41% ± 3.03; median: 29%; ICC: 0.92), and editorial independence (mean: 42.55% ± 4.57; median: 42%; ICC: 0.95). We considered a domain score of greater than 60% to represent an acceptable level of quality. We conclude that, overall, the quality of SCCHN guidelines is moderate in relation to international averages. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision making in this field.
我们开展了一项研究，以评估除鼻咽癌外的头颈部鳞状细胞癌（SCCHN）指南的质量。我们对美国国家指南资料库、加拿大医学协会信息库、指南国际网络、苏格兰跨学院指南网络、中国生物医学光盘、PubMed和Embase进行了电子检索。两名独立评审员使用《研究与评价指南II》（AGREE II）工具对符合条件的指南进行评估。使用组内相关系数（ICC）评估这些来源之间的一致程度。共发现514篇与临床指南相关的文章，49篇指南纳入我们的分析。为AGREE II的每个领域分配分数：范围和目的（平均值：71.63%±2.80；中位数：75%；ICC：0.76）、利益相关者参与（平均值：43.37%±2.96；中位数：50%；ICC：0.93）、制定的严谨性（平均值：45.63%±3.84；中位数：42%；ICC：0.83）、表述清晰度（平均值：68.08%±2.53；中位数：72%；ICC：0.85）、适用性（平均值：32.41%±3.03；中位数：29%；ICC：0.92）以及编辑独立性（平均值：42.55%±4.57；中位数：42%；ICC：0.95）。我们认为领域分数大于60%代表可接受的质量水平。我们得出结论，总体而言，SCCHN指南的质量与国际平均水平相比处于中等。需要做出更大努力以提供高质量指南，作为该领域临床决策有用且可靠的工具。
