Department of Urology, Baylor, Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
Division of Otolaryngology, Department of Surgery, Akron Childrens Hospital Akron, Ohio, U.S.A.
Laryngoscope. 2020 Jan;130(1):212-216. doi: 10.1002/lary.27722. Epub 2018 Dec 8.
Despite the importance, impact, and prevalence of pediatric hearing loss (HL), there are very few published clinical practice guidelines (CPG) supporting the evaluation and management of pediatric patients with HL. Our objective was to appraise existing CPGs to ensure safe and effective practices.
A literature search was conducted in PubMed, Google Scholar, EBSCO, as well as a manual Google search. Three independent assessors using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument evaluated CPGs related to HL in children. Standardized domain scores were calculated for each guideline.
A total of four guidelines met the inclusion criteria and were appraised. Scope and purpose achieved a high median score of 83%. Stakeholder involvement, clarity of presentation, and editorial independence achieved intermediate scores of 67%, 54%, and 50%, respectively. The areas that required most improvement and achieved low scores were rigor of development and applicability, with scores of 22% and 38%, respectively. Based on the AGREE II measures, the four guidelines had domain scores less than 60% for each domain, and without modification no guideline could be recommended.
Based on the AGREE II, the qualities of CPGs for pediatric HL have several shortcomings, and the need for a comprehensive CPG remains. Rigor of development and applicability present the greatest opportunities for improvement of these CPGs. Laryngoscope, 130:212-216, 2020.
尽管儿童听力损失（HL）具有重要性、影响力和普遍性，但支持评估和管理 HL 患儿的临床实践指南（CPG）却非常少。我们的目的是评估现有的 CPG，以确保安全有效的实践。
在 PubMed、Google Scholar、EBSCO 以及手动 Google 搜索中进行了文献检索。使用评估指南研究与评估 II（AGREE II）工具的三名独立评估员评估了与儿童 HL 相关的 CPG。为每个指南计算了标准化的领域评分。
共有 4 项指南符合纳入标准并进行了评估。范围和目的的得分为 83%，处于较高水平。利益相关者参与、表述清晰度和编辑独立性的得分为 67%、54%和 50%，处于中等水平。最需要改进且得分较低的领域是制定的严谨性和适用性，得分为 22%和 38%。根据 AGREE II 衡量标准，这 4 项指南的每个领域的评分均低于 60%，未经修改，没有一项指南可以被推荐。
根据 AGREE II，儿科 HL 的 CPG 质量存在一些缺陷，仍然需要制定全面的 CPG。制定的严谨性和适用性为这些 CPG 的改进提供了最大的机会。喉镜，130：212-216，2020。
