From the The First Clinical Medical College of Lanzhou University.
The Second Clinical Medical College of Lanzhou University.
J Clin Rheumatol. 2020 Mar;26(2):54-59. doi: 10.1097/RHU.0000000000000921.
The aim of this study was to assess the quality of global clinical practice guidelines (CPGs) on gout.
We systematically searched MEDLINE, CBM (Chinese Biomedical Literature database), GIN (Guidelines International Network), NICE (National Institute for Health and Clinical Excellence), NGC (National Guideline Clearinghouse), WHO (World Health Organization), SIGN (Scottish Intercollegiate Guidelines Network), DynaMed, UpToDate, and Best Practice databases from their inception until January 2017 to identify and select CPGs related to gout. Two reviewers independently assessed the eligible gout CPGs using the AGREE II instrument.
We evaluated 15 CPGs published between 2007 and 2017, produced by 13 different developers. Quality of evidence and strength of recommendations were presented in 14 (93%) and 13 (87%) CPGs, respectively. The mean scores (±SD) for each AGREE II domain were as follows: (i) scope and purpose: 75% (±17%), (ii) stakeholder involvement: 39% (±19%), (iii) rigor of development: 43% (±17%), (iv) clarity and presentation: 82% (±14%), (v) applicability: 31% (±12%), and (vi) editorial independence: 23% (±29%).
The quality of gout CPGs was suboptimal, and various incompatible grading systems of quality of evidence and strength of recommendations were used. The use of a standardized international grading system is essential to ensure high methodological quality of gout CPGs. Tools such as AGREE II could substantially improve the development and update of future gout CPGs.
本研究旨在评估全球痛风临床实践指南（CPG）的质量。
我们系统地检索了 MEDLINE、CBM（中国生物医学文献数据库）、GIN（指南国际网络）、NICE（英国国家卫生与临床优化研究所）、NGC（国家指南库）、WHO（世界卫生组织）、SIGN（苏格兰校际指南网络）、DynaMed、UpToDate 和 Best Practice 数据库，从建库至 2017 年 1 月，以确定和选择与痛风相关的 CPG。两名评审员使用 AGREE II 工具独立评估合格的痛风 CPG。
我们评估了 2007 年至 2017 年间发表的 15 项 CPG，由 13 个不同的开发者制作。14 项（93%）CPG 中提出了证据质量和推荐强度，13 项（87%）CPG 中提出了推荐强度。每个 AGREE II 领域的平均得分（±SD）如下：（i）范围和目的：75%（±17%），（ii）利益相关者参与：39%（±19%），（iii）制定严谨性：43%（±17%），（iv）清晰性和表述：82%（±14%），（v）适用性：31%（±12%），以及（vi）编辑独立性：23%（±29%）。
痛风 CPG 的质量不尽如人意，并且使用了各种不兼容的证据质量和推荐强度分级系统。使用标准化的国际分级系统对于确保痛风 CPG 的高质量方法学至关重要。AGREE II 等工具可以大大改进未来痛风 CPG 的制定和更新。
