School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
Injury Division, The George Institute for Global Health, Sydney, Australia.
Clin Exp Optom. 2021 Nov;104(8):864-870. doi: 10.1080/08164622.2021.1880862. Epub 2021 Feb 28.
: Understanding the quality of the commonly used clinical practice guidelines can help busy clinicians in selecting appropriate guidelines for evidence-based eye care for people with diabetes.: The National Health and Medical Research Council's (NHMRC) clinical practice guideline on diabetic retinopathy management has been widely used locally and internationally for over 10 years. However, the quality of this guideline has never been formally assessed. This study aimed to systematically evaluate the quality of the NHMRC guideline and compare it against other international guidelines.: The 2008 NHMRC and another five established diabetic retinopathy management international guidelines (Scottish Intercollegiate Guidelines Network, 2017; American Academy of Ophthalmology, 2019; American Optometric Association, 2019; Royal College of Ophthalmologists, UK, 2013, and Canadian Ophthalmologic Society, 2012) were examined using the Appraisal of Guidelines, Research and Evaluation (AGREE II) instrument. Scoring by four independent reviewers was aggregated into six domain and overall rating scores. Consistency among the reviewers was assessed using intraclass correlation coefficient (ICC).: The AGREE II domain scores for the NHMRC guideline were: scope and purpose 72%, stakeholder involvement 64%, rigour of development 77%, clarity of presentation 96%, applicability 35%, and editorial independence 15%. The NHMRC guideline's overall score (5.3 of 7) was lower than that of most other guidelines. Compared to others, the NHMRC guideline scored well in clarity of presentation and rigour of development, but less well for editorial independence. The NHMRC guideline was the least current and a need to update it was recognised by all reviewers who identified key areas for improvement.: The quality of the NHMRC guideline was comparable to most other established international guidelines. Several areas of strengths and weaknesses in this guideline were identified. Future updates should aim to improve transparency in development and applicability in clinical practice.
了解常用临床实践指南的质量有助于忙碌的临床医生为糖尿病患者选择基于证据的眼部护理的适当指南。
国家卫生和医学研究委员会（NHMRC）的糖尿病视网膜病变管理临床实践指南已在本地和国际上广泛使用了 10 多年。然而，该指南的质量从未经过正式评估。本研究旨在系统评估 NHMRC 指南的质量，并将其与其他国际指南进行比较。
使用评估、研究和评估（AGREE II）工具检查了 2008 年 NHMRC 指南和另外五个已建立的糖尿病视网膜病变管理国际指南（苏格兰校际指南网络，2017 年；美国眼科学会，2019 年；美国视光协会，2019 年；英国皇家眼科学院，2013 年和加拿大眼科学会，2012 年）。四名独立评审员的评分被汇总为六个领域和总体评分。使用组内相关系数（ICC）评估评审员之间的一致性。
NHMRC 指南的 AGREE II 领域得分分别为：范围和目的 72%，利益相关者参与 64%，制定的严谨性 77%，表述的清晰度 96%，适用性 35%和编辑独立性 15%。NHMRC 指南的总体评分（7 分中的 5.3 分）低于大多数其他指南。与其他指南相比，NHMRC 指南在表述清晰度和制定严谨性方面得分较高，但在编辑独立性方面得分较低。NHMRC 指南是最新的，所有评审员都认为需要更新，并确定了需要改进的关键领域。
NHMRC 指南的质量与大多数其他已建立的国际指南相当。该指南确定了一些优缺点。未来的更新应旨在提高开发的透明度和在临床实践中的适用性。
