Department of Pharmacy, Evidence-based Pharmacy Center, West China second hospital, Sichuan University, No. 20, Third Section, Renmin Nan Lu, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China.
Department of Pharmacy, Evidence-based Pharmacy Center, West China second hospital, Sichuan University, No. 20, Third Section, Renmin Nan Lu, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China; West China school of pharmacy, Sichuan University, Chengdu, China.
Psychiatry Res. 2018 Jan;259:385-391. doi: 10.1016/j.psychres.2017.08.060. Epub 2017 Aug 24.
To assess the methodological quality of existing clinical practice guidelines (CPGs) on the treatment of tic disorders (TDs) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and summarize the guideline recommendations. Five CPGs met our inclusion criteria. The mean percentages for the AGREE II domain scores were: scope and purpose 83.33% (95% confidence interval [CI], 77.78-94.44%), stakeholder involvement 62.22% (95% CI, 38.89-94.44%), rigor of development 47.08% (95% CI, 6.25-83.33%), clarity of presentation 87.78% (95% CI, 72.22-94.44%), applicability 56.67% (95% CI, 33.33-87.50%), and editorial independence 46.67% (95% CI, 8.33-91.67%). There were large differences among the five CPGs concerning the categorization of evidence and recommendations. The recommendations for drug therapy were similar in all five CPGs, although there was controversy in certain areas. The methodological quality of CPGs for TDs was acceptable in terms of scope and purpose, stakeholder involvement, and clarity of presentation. However, CPG developers need to pay more attention to rigorous development processes, applicability, and editorial independence. Developers of future CPGs should improve adherence to the AGREE II guidelines. In addition, high quality studies on the treatment of TDs are needed to provide more evidence for developing guidelines.
采用评估健康保健领域指南的研究与评价工具（AGREE II）评估现有的 tic 障碍（TDs）治疗临床实践指南（CPGs）的方法学质量，并总结指南建议。符合纳入标准的 CPG 有 5 项。AGREE II 各领域评分的平均百分比为：范围和目的 83.33%（95%置信区间 [CI]，77.78-94.44%），利益相关者参与 62.22%（95% CI，38.89-94.44%），制定的严谨性 47.08%（95% CI，6.25-83.33%），表述的清晰性 87.78%（95% CI，72.22-94.44%），适用性 56.67%（95% CI，33.33-87.50%），编辑独立性 46.67%（95% CI，8.33-91.67%）。在证据分类和建议方面，这 5 项 CPG 之间存在很大差异。虽然在某些领域存在争议，但 5 项 CPG 对药物治疗的建议是相似的。从范围和目的、利益相关者参与以及表述的清晰性来看，TDs CPG 的方法学质量是可以接受的。然而，CPG 开发者需要更加关注严格的开发过程、适用性和编辑独立性。未来 CPG 的开发者应该提高对 AGREE II 指南的遵循程度。此外，还需要开展高质量的 TD 治疗研究，为指南制定提供更多证据。
