Xie Zhenwei, Wang Xiaoling, Sun Lin, Liu Jun, Guo Yan, Xu Baoping, Zhao Libo, Shen Adong
Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
School of Pharmaceutical Science, Peking University, Beijing, 100191, China.
BMC Pediatr. 2016 Aug 2;16:119. doi: 10.1186/s12887-016-0651-5.
Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality worldwide among children. The growing number of guidelines have been accompanied with a growing concern about variance and conflicts among guideline recommendations. There is a need to critically appraise clinical practice guidelines (CPGs) in order to ensure safe and effective practices.
A literature search was systematically conducted in English and Chinese major academic databases (from January 2000 to March 2015). CPGs related to CAP in children were evaluated by four independent assessors, according to AGREE II instruments. Standardized domain scores were calculated for each guideline. Inter-rater reliability was assessed by intraclass correlation coefficient. The software used for analysis was SPSS 17.0.
A total of 10 guidelines met the inclusion criteria and were appraised. Scope and purpose (69.03 %) and clarity of presentation (83.33 %) achieved relative high scores, while the scores of the other four domains were low: stakeholder involvement (42.78 %), rigour of development (44.95 %), applicability (37.60 %), and editorial independence (23.74 %). 3 guidelines were strongly recommended as a result of the overall scores were greater than 60 %.
The qualities of CPGs for CAP in children were generally acceptable with several flaws. Stakeholder involvement, rigour of development, applicability and editorial independence should be considered and well described in the future development of CPGs.
社区获得性肺炎（CAP）仍是全球儿童发病和死亡的主要原因。随着指南数量的不断增加，人们越来越关注指南建议之间的差异和冲突。有必要对临床实践指南（CPG）进行严格评估，以确保安全有效的实践。
在英文和中文主要学术数据库中系统检索文献（2000年1月至2015年3月）。4名独立评估者根据AGREE II工具对儿童CAP相关的CPG进行评估。计算每个指南的标准化领域得分。通过组内相关系数评估评估者间的可靠性。用于分析的软件为SPSS 17.0。
共有10项指南符合纳入标准并进行了评估。范围和目的（69.03%）及表述清晰度（83.33%）得分相对较高，而其他四个领域得分较低：利益相关者参与度（42.78%）、制定严谨性（44.95%）、适用性（37.60%）和编辑独立性（23.74%）。由于总分大于60%，3项指南被强烈推荐。
儿童CAP的CPG质量总体上可以接受，但存在一些缺陷。在CPG的未来发展中，应考虑并充分描述利益相关者参与度、制定严谨性、适用性和编辑独立性。
