From the Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, Michigan (MPD, SRM); Kessler Institute for Rehabilitation, West Orange, New Jersey (IW); Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey (IW); Department of Physical Medicine and Rehabilitation, VA North Texas Health Care System and UT Southwestern Medical Center, Dallas, Texas (TA); Educational Psychology Department, University of Texas, Austin, Texas (DD); Strauss Heath Sciences Library, University of Colorado, Aurora, Colorado (LH); and Department of Emergency Medicine, Wayne State University, Detroit, Michigan (SRM).
Am J Phys Med Rehabil. 2021 Aug 1;100(8):790-797. doi: 10.1097/PHM.0000000000001645.
The aim of the study was to determine what factors determine the quality of rehabilitation clinical practice guidelines.
Six databases were searched for articles that had applied the Appraisal of Guidelines for Research & Evaluation II quality assessment tool to rehabilitation clinical practice guidelines. The 573 deduplicated abstracts were independently screened by two authors, resulting in 81 articles, the full texts of which were independently screened by two authors for Appraisal of Guidelines for Research & Evaluation II application to rehabilitation clinical practice guidelines, resulting in a final selection of 40 reviews appraising 504 clinical practice guidelines. Data were extracted from these by one author and checked by a second. Data on each clinical practice guideline included the six Appraisal of Guidelines for Research & Evaluation II domain scores, as well as the two Appraisal of Guidelines for Research & Evaluation II global evaluations.
All six Appraisal of Guidelines for Research & Evaluation II domain scores were statistically significant predictors of overall clinical practice guideline quality rating; D3 (rigor of development) was the strongest and D1 (scope and purpose) the weakest (overall model P < 0.001, R2 = 0.53). Five of the six domain scores were significant predictors of the clinical practice guideline use recommendation, with D3 the strongest predictor and D5 (applicability) the weakest (overall model P < 0.001, pseudo R2 = 0.53).
Quality of rehabilitation clinical practice guidelines may be improved by addressing key domains such as rigor of development.
本研究旨在确定哪些因素决定康复临床实践指南的质量。
检索了六个数据库，以寻找应用评估研究与评估工具 II（AGREE II）质量评估工具对康复临床实践指南进行评估的文章。对 573 篇去重摘要进行了两位作者的独立筛选，结果有 81 篇文章，这些文章的全文由两位作者独立筛选，以评估其在康复临床实践指南中的应用，最终选择了 40 篇综述，评估了 504 项临床实践指南。一位作者从这些综述中提取数据，并由第二位作者进行核对。每条临床实践指南的数据包括 AGREE II 的六个领域评分，以及 AGREE II 的两个总体评估。
AGREE II 的所有六个领域评分均为临床实践指南质量总体评分的统计学显著预测因子；D3（制定的严谨性）最强，D1（范围和目的）最弱（总体模型 P < 0.001，R2 = 0.53）。六个领域评分中有五个是临床实践指南使用建议的显著预测因子，D3 是最强的预测因子，D5（适用性）是最弱的（总体模型 P < 0.001，拟 R2 = 0.53）。
通过解决制定的严谨性等关键领域，可能会提高康复临床实践指南的质量。
