Department of Surgery and Cancer, Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, London, United Kingdom.
Department of Surgery and Cancer, Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, London, United Kingdom.
J Vasc Surg Venous Lymphat Disord. 2021 May;9(3):787-791.e3. doi: 10.1016/j.jvsv.2020.09.014. Epub 2020 Nov 26.
Our aim was to assess the methodologic quality of clinical practice guidelines (CPGs), which inform the diagnosis and management of chronic venous disease (CVD), using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.
A systematic review was performed through the Medline and Embase databases to identify CPGs relevant to CVD. The included articles were evidence-based CPGs available in English and reported in the past 20 years. Consensus documents, expert opinions, and studies providing guidance for diagnosis or treatment alone were excluded. Four independent reviewers assessed the CPGs using the AGREE II tool across six domains. Overall quality scaled scores were calculated for each guideline, and the interrater reliability was measured using an intraclass correlation coefficient. SPSS, version 25 (IBM Corp, Armonk, NY) was used for statistical analysis.
Six CPGs reported from 2004 to 2018 were identified; all were of European and North American origin. The interrater reliability when scoring each CPG was high, with an intraclass correlation coefficient of >0.8 (P ≤ .002) for all six CPGs. One CPG had an average score of 95.83% across all domains, qualifying as a high quality CPG. The remaining five CPGs had scores ranging from 29% to 71%. The CPGs generally performed poorly in outlining stakeholder involvement and evaluating the applicability of the guideline to clinical practice.
Scores from the AGREE II tool were reproducible when different users evaluated the CPGs. We identified one CPG for CVD of high methodologic quality. The AGREE II appraisal tool can be used to identify aspects of CPGs that can be developed to improve their methodologic quality.
使用评估指南研究与评估 II （AGREE II）工具评估为慢性静脉疾病（CVD）的诊断和管理提供信息的临床实践指南（CPG）的方法学质量。
通过 Medline 和 Embase 数据库进行系统评价，以确定与 CVD 相关的 CPG。纳入的文章是过去 20 年发表的基于证据的 CPG，以英文提供。排除共识文件、专家意见和仅提供诊断或治疗指导的研究。四位独立审稿人使用 AGREE II 工具评估了六个领域的 CPG。为每个指南计算了整体质量评分量表，并使用组内相关系数测量了评分者间的可靠性。使用 SPSS，版本 25（IBM 公司，纽约州阿蒙克）进行统计分析。
确定了 2004 年至 2018 年报道的 6 项 CPG；均为欧洲和北美的来源。对每个 CPG 进行评分时，评分者间的可靠性较高，所有 6 项 CPG 的组内相关系数均>0.8（P≤0.002）。一项 CPG 在所有领域的平均得分为 95.83%，为高质量 CPG。其余 5 项 CPG 的得分范围为 29%至 71%。这些 CPG 在概述利益相关者参与和评估指南对临床实践的适用性方面普遍表现不佳。
当不同用户评估 CPG 时，AGREE II 工具的评分具有可重复性。我们确定了一项 CVD 的高质量 CPG。AGREE II 评估工具可用于确定可用于提高其方法学质量的 CPG 方面。
