Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau, Barcelona, Spain.
Department of Research, Faculty of Dentistry, University of Cartagena, Campus de la Salud, Zaragocilla Cra. 50 # 29-11, CP, 130014, Cartagena, Colombia.
Clin Oral Investig. 2019 May;23(5):2215-2226. doi: 10.1007/s00784-018-2668-7. Epub 2018 Oct 3.
To assess the quality of clinical practice guidelines (CPGs) on screening and diagnosis of oral cancer and to describe the characteristics of their recommendations.
We systematically searched EMBASE, MEDLINE, CPG' websites, and dentistry and oncology scientific societies to identify CPGs that were related to screening and diagnosis of oral cancer. The quality of selected CPGs was independently assessed by four appraisers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The inter-appraiser agreement was assessed. We performed a descriptive analysis of the recommendations included in the selected CPGs.
Eight CPGs were selected. The overall agreement among reviewers was considered very good (ICC: 0.823; 95% CI: 0.777-0.861). The median scores of the six AGREE II domains were as follows: "scope and purpose" 97.9% (IQR: 96.2-100.0%); "stakeholder involvement" 86.1% (IQR: 69.8-93.1%); "rigor of development" 75.3% (IQR: 64.2-94.3%); "clarity of presentation" 91.7% (IQR: 82.6-94.4%); "applicability" 53.1% (IQR: 19.3-74.2%); and "editorial independence" 83.3% (IQR: 67.2-93.8%). Four CPGs were assessed as "recommended", four "recommended with modifications", and none "not recommended". Twenty-three recommendations were provided, mostly with a low or very low level of evidence.
The methodological quality of CPGs on screening and diagnosis of oral cancer is moderate. The "applicability" domain scored the lowest. Most recommendations were based on a low o very low level of evidence.
Greater efforts are needed to provide healthcare based on high-quality evidence-based CPGs in this field.
评估口腔癌筛查和诊断临床实践指南（CPG）的质量，并描述其建议的特征。
我们系统地检索了 EMBASE、MEDLINE、CPG 网站以及牙科和肿瘤学会，以确定与口腔癌筛查和诊断相关的 CPG。四位评估员使用评估指南研究和评估 II（AGREE II）工具独立评估选定 CPG 的质量。评估了评估员之间的一致性。我们对选定 CPG 中包含的建议进行了描述性分析。
共纳入 8 篇 CPG。审稿人之间的总体一致性被认为非常好（ICC：0.823；95%CI：0.777-0.861）。AGREE II 六个领域的中位数评分如下：“范围和目的”97.9%（IQR：96.2-100.0%）；“利益相关者参与”86.1%（IQR：69.8-93.1%）；“制定的严谨性”75.3%（IQR：64.2-94.3%）；“表述的清晰度”91.7%（IQR：82.6-94.4%）；“适用性”53.1%（IQR：19.3-74.2%）；“编辑独立性”83.3%（IQR：67.2-93.8%）。4 篇 CPG 被评为“推荐”，4 篇 CPG 被评为“推荐修改”，没有 CPG 被评为“不推荐”。共提出了 23 条建议，这些建议大多基于低或极低水平的证据。
口腔癌筛查和诊断 CPG 的方法学质量中等。“适用性”领域得分最低。大多数建议基于低或极低水平的证据。
在该领域，需要更加努力地提供基于高质量循证 CPG 的医疗保健。
