Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Barcelona, Spain; Department of Research, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia; Public Health and Clinical Epidemiology Service, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Cochrane Argentina, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina.
Cancer Treat Rev. 2018 Apr;65:47-53. doi: 10.1016/j.ctrv.2018.03.001. Epub 2018 Mar 10.
The applicability of clinical practice guidelines (CPGs) on treatments for oral cancer remains unknown since there are no systematic assessments of their quality. Thus, the objective of this study is to identify and assess the quality of them.
We conducted a systematic search to identify CPGs that provided recommendations on treatments for oral cancer. The quality of each included CPG was determined using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, by four appraisers independently. The inter-appraisers agreement was assessed.
Twelve CPGs met the eligibility criteria. Overall agreement among appraisers was very good (ICC: 0.865; 95% CI: 0.835-0.889). The mean scores for each AGREE domain were the following: "scope and purpose" 88.4%±12.4%; "stakeholder involvement" 60.4%±25%; "rigor of development" 60.9%±25.3%; "clarity of presentation" 76.5%±19.8%; "applicability" 32.2%±30.7%; and "editorial independence" 61.6%±35.5%. Three CPGs were rated as "recommended"; six as "recommended with modifications"; and three as "not recommended".
Overall, the quality of CPGs on treatments for oral cancer is suboptimal. These findings highlight the need to improve CPG development processes and their applicability in this field. Thus, increased efforts are required to enable the development of high-quality evidence-based CPGs for oral cancer.
由于缺乏对其质量的系统评估，临床实践指南（CPG）在口腔癌治疗方面的适用性尚不清楚。因此，本研究的目的是确定并评估其质量。
我们进行了系统检索，以确定提供口腔癌治疗建议的 CPG。由四位评估员独立使用评估研究和评估指南 II（AGREE II）工具来确定每个纳入 CPG 的质量。评估了评估者之间的一致性。
符合纳入标准的 CPG 有 12 项。评估者之间的总体一致性非常好（ICC：0.865；95%CI：0.835-0.889）。每个 AGREE 域的平均得分如下：“范围和目的”88.4%±12.4%；“利益相关者参与”60.4%±25%；“制定的严谨性”60.9%±25.3%；“表述的清晰度”76.5%±19.8%；“适用性”32.2%±30.7%；“编辑独立性”61.6%±35.5%。有 3 项 CPG 被评为“推荐”；6 项被评为“推荐，有修改”；3 项被评为“不推荐”。
总体而言，口腔癌治疗 CPG 的质量不尽如人意。这些发现强调需要改进 CPG 制定流程及其在该领域的适用性。因此，需要加大努力制定高质量的循证口腔癌 CPG。
