Dickson Catherine, Arnason Trevor, Friedman Dara Spatz, Metz Gila, Grimshaw Jeremy M
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Ottawa Public Health, Ottawa, Canada.
Sex Transm Infect. 2017 Nov;93(7):487-492. doi: 10.1136/sextrans-2016-052939. Epub 2017 Mar 30.
Clinical guidelines help ensure consistent care informed by current evidence. As shifts in antimicrobial resistance continue to influence first-line treatment, up-to-date guidelines are important for preventing treatment failure. A guideline's development process will influence its recommendations and users' trust.
To assess the quality of current gonorrhoea guidelines' development processes.
Multiple databases.
Original and current English-language guidelines targeting health professionals and containing treatment recommendations for uncomplicated gonorrhoea in the general adult population.
Two appraisers assessed the guidelines independently using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Scores were combined as per the AGREE II users' manual.
We identified 10 guidelines meeting the inclusion criteria. The quality of the gonorrhoea treatment guidelines varied. Most scored poorly on ; information on the evidence review process and methods for formulating recommendations was often missing. The and scored the highest on . Methods to address conflicts of interest were often not described in the materials reviewed. Implementation of recommendations was often not addressed.
By limiting our study to English-language guidelines, a small number of guidelines we identified were excluded. Our analysis was limited to either published or online materials that were readily available to users. We could not differentiate between items addressed in the development process but not documented from items that were not addressed.
Gonorrhoea treatment guidelines may slow antimicrobial resistance. Many current guidelines are not in line with the current guideline development best practices; this might undermine the perceived trustworthiness of guidelines. By identifying current limitations, this study can help improve the quality of future guidelines.
临床指南有助于确保依据当前证据提供一致的治疗。随着抗菌药物耐药性的变化持续影响一线治疗，最新的指南对于预防治疗失败至关重要。指南的制定过程会影响其推荐意见以及用户的信任度。
评估当前淋病指南制定过程的质量。
多个数据库。
针对卫生专业人员的英文原版及现行指南，且包含一般成年人群单纯性淋病的治疗推荐。
两名评估者使用《研究与评价指南评估II》（AGREE II）工具独立评估指南。分数按照AGREE II用户手册进行合并。
我们识别出10份符合纳入标准的指南。淋病治疗指南的质量参差不齐。大多数在 方面得分较低；关于证据审查过程和推荐意见制定方法的信息常常缺失。 和 在 方面得分最高。在审查的材料中，通常未描述处理利益冲突的方法。推荐意见的实施情况常常未涉及。
通过将研究局限于英文指南，我们识别出的少数指南被排除在外。我们的分析仅限于用户可轻易获取的已发表或在线材料。我们无法区分制定过程中涉及但未记录的项目与未涉及的项目。
淋病治疗指南可能减缓抗菌药物耐药性。许多现行指南不符合当前指南制定的最佳实践；这可能会削弱指南的可信度。通过识别当前的局限性，本研究有助于提高未来指南的质量。
