Ng Jeremy Y, Nault Hayley, Nazir Zainib
Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Integr Med Res. 2021 Mar;10(1):100452. doi: 10.1016/j.imr.2020.100452. Epub 2020 Jun 20.
Complementary and integrative medicine (CIM) use is widely sought by those diagnosed with cancer, with up to 50% of lung cancer patients seeking these therapies in the United States. The purpose of this study was to identify the quantity and assess the quality of CIM recommendations in clinical practice guidelines (CPGs) for the treatment and/or management of lung cancer.
A systematic review was conducted to identify lung cancer CPGs. MEDLINE, EMBASE and CINAHL were searched from 2008 to 2018, along with the Guidelines International Network and the National Center for Complementary and Integrative Health websites. Eligible guidelines containing recommendations for the treatment and/or management of lung cancer were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument.
From 589 unique search results, 4 guidelines mentioned CIM, of which 3 guidelines made CIM recommendations. Scaled domain percentages from highest to lowest were: scope and purpose (82.4% overall, 76.9% CIM), clarity and presentation (96.3% overall, 63.0% CIM), editorial independence (61.1% overall, 61.1% CIM), rigour of development (62.5% overall, 54.9% CIM), stakeholder involvement (66.7% overall, 42.6% CIM) and applicability (29.9% overall, 18.8% CIM). Quality varied within and across guidelines.
Guidelines that scored well could serve as a framework for discussion between patients and healthcare professionals regarding use of CIM therapies in the context of lung cancer. Guidelines that scored lower could be improved according to the AGREE II instrument, with insight from other guidelines development resources.
癌症患者广泛寻求补充和整合医学（CIM）疗法，在美国，高达50%的肺癌患者寻求这些疗法。本研究的目的是确定肺癌治疗和/或管理的临床实践指南（CPG）中CIM推荐的数量并评估其质量。
进行系统评价以确定肺癌CPG。检索了2008年至2018年的MEDLINE、EMBASE和CINAHL，以及指南国际网络和补充与整合健康国家中心网站。使用《指南研究与评价II》（AGREE II）工具评估包含肺癌治疗和/或管理推荐的合格指南。
从589个独特的搜索结果中，4份指南提及了CIM，其中3份指南给出了CIM推荐。按比例从高到低的领域百分比分别为：范围和目的（总体82.4%，CIM为76.9%）、清晰性和呈现方式（总体96.3%，CIM为63.0%）、编辑独立性（总体61.1%，CIM为61.1%）、制定的严谨性（总体62.5%，CIM为54.9%）、利益相关者参与度（总体66.7%，CIM为42.6%）和适用性（总体29.9%，CIM为18.8%）。不同指南内部和之间的质量存在差异。
得分较高的指南可作为患者与医疗保健专业人员就肺癌背景下使用CIM疗法进行讨论的框架。得分较低的指南可根据AGREE II工具进行改进，并借鉴其他指南制定资源的见解。
