儿童发热症状管理指南:文献系统评价及AGREE II质量评估

Guidelines for the symptomatic management of fever in children: systematic review of the literature and quality appraisal with AGREE II.

作者信息

Chiappini Elena, Bortone Barbara, Galli Luisa, de Martino Maurizio

机构信息

Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.

出版信息

BMJ Open. 2017 Jul 31;7(7):e015404. doi: 10.1136/bmjopen-2016-015404.

Abstract

INTRODUCTION

Several societies have produced and disseminated clinical practice guidelines (CPGs) for the symptomatic management of fever in children. However, to date, the quality of such guidelines has not been appraised.

OBJECTIVE

To identify and evaluate guidelines for the symptomatic management of fever in children.

METHODS

The research was conducted using PubMed, guideline websites, and Google (January 2010 to July 2016). The quality of the CPGs was independently assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, and specific recommendations in guidelines were summarised and evaluated. Domain scores were considered of sufficient quality when >60% and of good quality when >80%.

RESULTS

Seven guidelines were retrieved. The median score for the scope and purpose domain was 85.3% (range 66.6-100%). The median score for the stakeholder involvement domain was 57.5% (range 33.3-83.3%) and four guidelines scored >60%. The median score for the rigour of development domain was 52.0% (range 14.6-98.9%), and only three guidelines scored >60%. The median score for the clarity of presentation domain was 80.9% (range 50.0-94.4%). The median score for the applicability domain was 39.3% (8.3-100%). Only one guideline scored >60%. The median score for the editorial independence domain was 48.84% (0-91.6%); only three guidelines scored >60%.

CONCLUSION

Most guidelines were recommended for use even if with modification, especially in the methodology, the applicability and the editorial independence domains. Our results could help improve reporting of future guidelines, and affect the selection and use of guidelines in clinical practice.

摘要

引言

多个学会已制定并发布了关于儿童发热症状管理的临床实践指南(CPG)。然而,迄今为止,此类指南的质量尚未得到评估。

目的

识别并评估儿童发热症状管理的指南。

方法

研究于2010年1月至2016年7月期间通过PubMed、指南网站及谷歌进行。两位评估者使用《研究与评估指南II》(AGREE II)工具对CPG的质量进行独立评估,并总结和评估指南中的具体建议。当领域得分>60%时,认为质量足够;当得分>80%时,认为质量良好。

结果

共检索到七项指南。范围和目的领域的中位数得分是85.3%(范围66.6 - 100%)。利益相关者参与领域的中位数得分是57.5%(范围33.3 - 83.3%),四项指南得分>60%。制定的严谨性领域的中位数得分是52.0%(范围14.6 - 98.9%),只有三项指南得分>60%。呈现的清晰度领域的中位数得分是80.9%(范围50.0 - 94.4%)。适用性领域的中位数得分是39.3%(8.3 - 100%)。只有一项指南得分>60%。编辑独立性领域的中位数得分是48.84%(0 - 91.6%);只有三项指南得分>60%。

结论

即使需要修改,大多数指南仍被推荐使用,尤其是在方法学、适用性和编辑独立性领域。我们的结果有助于改进未来指南的报告,并影响临床实践中指南的选择和使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a69/5642818/19657a04aff6/bmjopen-2016-015404f01.jpg

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