Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou City, Gansu Province, China.
Eye (Lond). 2020 Nov;34(11):1989-2000. doi: 10.1038/s41433-020-1010-1. Epub 2020 Jun 24.
To present an evidence map for explicating research trends and gaps, we systematically review clinical practice guidelines (CPGs) on diabetic retinopathy (DR) and assess the quality of CPGs and consistency of recommendations. A literature search was performed in PubMed, Embase, Web of Science, CPG databases, and website of diabetes society to include the CPGs. The basic information, methodological quality, and reporting quality of CPGs, recommendations for DR were exacted by the Excel 2013. Methodological and reporting quality of DR CPGs were evaluated by AGREE II instrument and RIGHT checklist. The bubble plot format of evidence map was made by Excel 2013. Nineteen CPGs proved eligible, which included eight DR CPGs and 11 comprehensive diabetic CPGs. The identified CPGs were of mixed quality and they scored poorly in the rigor of development, applicability domains by AGREE II. Field two (background) had the highest reporting rate (86.31%) and field five (review and quality assurance) obtained the lowest reporting rate (31.58%) among the seven domains of RIGHT checklist. According to the recommendations of CPGs, there were three inconsistencies in the screening of DR, and CPGs recommendations for treatment were consistent on the whole. At the same time, recommendations for laser therapy were not accurate. Some recommendations were not specific and clear in some DR CPGs. This evidence map could collect and evaluate the characteristics of published CPGs, add to our knowledge and promote the development of trustworthy CPGs for DR.
为了呈现一个阐明研究趋势和差距的证据图谱，我们系统地回顾了关于糖尿病视网膜病变（DR）的临床实践指南（CPGs），并评估了 CPG 的质量和建议的一致性。我们在 PubMed、Embase、Web of Science、CPG 数据库和糖尿病学会网站上进行了文献检索，以纳入 CPG。我们使用 Excel 2013 提取 CPG 的基本信息、方法学质量和报告质量，以及 DR 的建议。我们使用 AGREE II 工具和 RIGHT 清单评估 DR CPG 的方法学和报告质量。我们使用 Excel 2013 制作了证据图谱的气泡图格式。最终确定了 19 项符合条件的 CPG，其中包括 8 项 DR CPG 和 11 项综合糖尿病 CPG。确定的 CPG 质量参差不齐，在 AGREE II 的严谨性和适用性领域得分较低。RIGHT 清单的七个领域中，领域二（背景）的报告率最高（86.31%），领域五（审查和质量保证）的报告率最低（31.58%）。根据 CPG 的建议，DR 筛查存在三个不一致之处，总体而言，CPG 对治疗的建议是一致的。同时，激光治疗的建议不够准确。一些 CPG 对 DR 的建议不够具体和明确。这个证据图谱可以收集和评估已发表 CPG 的特点，增加我们的知识，并促进值得信赖的 DR CPG 的发展。
