Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America.
PLoS One. 2018 Oct 3;13(10):e0204720. doi: 10.1371/journal.pone.0204720. eCollection 2018.
Clinical practice guidelines contain recommendations for physicians to determine the most appropriate care for patients. These guidelines systematically combine scientific evidence and clinical judgment, culminating in recommendations intended to optimize patient care. The recommendations in CPGs are supported by evidence which varies in quality. We aim to survey the clinical practice guidelines created by the American College of Gastroenterology, report the level of evidence supporting their recommendations, and identify areas where evidence can be improved with additional research.
We extracted 1328 recommendations from 39 clinical practice guidelines published by the American College of Gastroenterology. Several of the clinical practice guidelines used the differing classifications of evidence for their recommendations. To standardize our results, we devised a uniform system for evidence.
A total of 39 clinical practice guidelines were surveyed in our study. Together they account for 1328 recommendations. 693 (52.2%) of the recommendations were based on low evidence, indicating poor evidence or expert opinion. Among individual guidelines, 13/39 (33.3%) had no recommendations based on high evidence.
Very few recommendations made by the American College of Gastroenterology are supported by high levels of evidence. More than half of all recommendations made by the American College of Gastroenterology are based on low-quality evidence or expert opinion.
临床实践指南包含了医生为患者确定最合适的治疗方案的建议。这些指南系统地结合了科学证据和临床判断，最终形成旨在优化患者治疗的建议。指南中的建议得到了不同质量的证据的支持。我们旨在调查美国胃肠病学会制定的临床实践指南，报告支持其建议的证据水平，并确定在哪些领域可以通过进一步研究来改进证据。
我们从美国胃肠病学会发表的 39 份临床实践指南中提取了 1328 条建议。其中一些临床实践指南使用了不同的证据分类来为其建议分级。为了使我们的结果标准化，我们设计了一个统一的证据系统。
我们对 39 份临床实践指南进行了调查，这些指南共包含 1328 条建议。其中 693 条（52.2%）建议的证据水平较低，表明证据质量较差或仅基于专家意见。在个别指南中，有 13/39（33.3%）的指南没有基于高证据的建议。
美国胃肠病学会提出的建议中，很少有得到高证据水平的支持。超过一半的美国胃肠病学会提出的建议都是基于低质量的证据或专家意见。
