Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Musculoskelet Sci Pract. 2021 Feb;51:102295. doi: 10.1016/j.msksp.2020.102295. Epub 2020 Nov 7.
Low back pain (LBP) is highly prevalent in the general population and is responsible for increased health-care costs, pain, impairment of activity, and if chronic, is associated with a range of comorbidities.
The purpose of this review was to identify the quantity and assess the quality of evidence-based clinical practice guidelines (CPGs) for the treatment and/or management of LBP in adults.
MEDLINE, EMBASE, CINAHL, and the Guidelines International Network were systematically searched from 2008 to 2018 to identify LBP CPGs. Eligible CPGs were assessed in duplicate using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument across 6 domains: scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence.
Of 181 unique search results, 22 CPGs for the treatment and/or management of LBP were eligible. Scaled domain percentages from highest to lowest were: scope and purpose (90.0%), clarity of presentation (84.0%), stakeholder involvement (54.0%), rigour of development (51.2%), editorial independence (39.6%) and applicability (28.5%). Quality varied within and across CPGs.
CPGs varied in quality, with most scoring the highest in the scope and purpose and clarity of presentation domains. CPGs achieved variable and lower scores in the stakeholder involvement, rigour of development, applicability, and editorial independence domains. CPGs with higher AGREE II scores can serve as suitable evidence-based resources for clinicians involved in LBP care; CPGs with lower scores could be improved in future updates using the AGREE II instrument, among other guideline development resources, as a guide.
腰痛（LBP）在普通人群中发病率很高，导致医疗保健费用增加、疼痛、活动能力受损，如果是慢性的，还与一系列合并症有关。
本综述的目的是确定治疗成人腰痛（LBP）的基于证据的临床实践指南（CPG）的数量，并评估其质量。
系统检索了 MEDLINE、EMBASE、CINAHL 和指南国际网络，以从 2008 年到 2018 年确定 LBP CPG。使用评估指南研究和评估 II（AGREE II）工具对符合条件的 CPG 进行了双重评估，涵盖了 6 个领域：范围和目的、利益相关者参与、制定的严谨性、表述的清晰度、适用性和编辑独立性。
从 181 个独特的搜索结果中，有 22 个治疗和/或管理腰痛的 CPG 符合条件。从最高到最低的比例分别是：范围和目的（90.0%）、表述的清晰度（84.0%）、利益相关者的参与（54.0%）、制定的严谨性（51.2%）、编辑独立性（39.6%）和适用性（28.5%）。指南的质量在不同指南之间存在差异。
CPG 的质量存在差异，大多数在范围和目的以及表述的清晰度方面得分最高。CPG 在利益相关者的参与、制定的严谨性、适用性和编辑独立性方面的得分较低。具有较高 AGREE II 评分的 CPG 可以作为参与 LBP 护理的临床医生的合适的基于证据的资源；得分较低的 CPG 可以在未来的更新中使用 AGREE II 工具进行改进，以及其他指南制定资源，作为指南。
