Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Department of Pediatrics, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
BMC Pregnancy Childbirth. 2020 Oct 7;20(1):595. doi: 10.1186/s12884-020-03241-y.
The management of pregnant women with sickle cell disease (SCD) poses a major challenge for maternal healthcare services owing to the potential for complications associated with morbidity and mortality. Trustworthy evidence-based clinical practice guidelines (CPGs) have a major impact on the positive outcomes of appropriate healthcare. The objective of this study was to critically appraise the quality of recent CPGs for SCD in pregnant women.
Clinical questions were identified and the relevant CPG and bibliographic databases were searched and screened for eligible CPGs. Each CPG was appraised by four independent appraisers using the AGREE II Instrument. Inter-rater analysis was conducted.
Four eligible CPGs were appraised: American College of Obstetricians and Gynecologists (ACOG), National Heart, Lung, and Blood Institute (NHLBI), National Institute of Health and Care Excellence (NICE), and Royal College of Obstetricians and Gynaecologists (RCOG). Among them, the overall assessments of three CPGs (NICE, RCOG, NHLBI) scored greater than 70%; these findings were consistent with the high scores in the six domains of AGREE II, including:[1] scope and purpose,[2] stakeholder involvement,[3] rigor of development,[4] clarity of presentation,[5] applicability, and [6] editorial independence domains. Domain [3] scored (90%, 73%, 71%), domain [5] (90%, 46%, 47%), and domain [6] (71%, 77%, 52%) for NICE, RCOG, and NHLBI, respectively. Overall, the clinical recommendations were not significantly different between the included CPGs.
Three evidence-based CPGs presented superior methodological quality. NICE demonstrated the highest quality followed by RCOG and NHLBI and all three CPGs were recommended for use in practice.
由于与发病率和死亡率相关的并发症的潜在风险，患有镰状细胞病（SCD）的孕妇的管理对孕产妇保健服务构成了重大挑战。值得信赖的基于证据的临床实践指南（CPG）对适当医疗保健的积极结果有重大影响。本研究的目的是批判性地评估最近针对孕妇 SCD 的 CPG 的质量。
确定临床问题，并搜索和筛选相关的 CPG 和参考书目数据库，以确定符合条件的 CPG。四位独立评估员使用 AGREE II 工具评估每个 CPG。进行了内部评估员分析。
评估了四个合格的 CPG：美国妇产科医师学会（ACOG）、美国国家心肺血液研究所（NHLBI）、英国国家卫生与保健卓越研究所（NICE）和英国皇家妇产科医师学院（RCOG）。其中，三个 CPG（NICE、RCOG、NHLBI）的总体评估得分均超过 70%；这一发现与 AGREE II 的六个领域的高分一致，包括：[1]范围和目的、[2]利益相关者参与、[3]开发的严谨性、[4]表述的清晰度、[5]适用性和[6]编辑独立性领域。在 NICE、RCOG 和 NHLBI 中，领域[3]的评分分别为（90%、73%、71%），领域[5]的评分分别为（90%、46%、47%），领域[6]的评分分别为（71%、77%、52%）。总体而言，纳入的 CPG 之间的临床建议没有显著差异。
三个基于证据的 CPG 表现出较高的方法学质量。NICE 表现出最高的质量，其次是 RCOG 和 NHLBI，这三个 CPG 都被推荐用于实践。
