Imperial College Healthcare NHS Trust, Hammersmith Hospital, UK.
Cambridge University Hospitals NHS Foundation Trust, UK.
Ann R Coll Surg Engl. 2021 Jul;103(7):471-477. doi: 10.1308/rcsann.2021.0013. Epub 2021 Apr 14.
Diverticular disease is one of the most frequent reasons for attending emergency departments and surgical causes of hospital admission. In the past decade, many surgical and gastroenterological societies have published guidelines for the management of diverticular disease. The aim of the present study was to appraise the methodological quality of these guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool.
PubMed, Embase, Cochrane Library and Google Scholar databases were searched systematically. The methodological quality of the guidelines was appraised independently by five appraisers using the AGREE II instrument.
A systematic search of the literature identified 12 guidelines. The median overall score of all guidelines was 68%. Across all guidelines, the highest score of 85% was demonstrated in the domain 'Scope and purpose'. The domains 'Clarity and presentation' and 'Editorial independence' both scored a median of 72%. The lowest scores were demonstrated in the domains 'Stakeholder involvement' and 'Applicability' at 46% and 40%, respectively. Overall, the National Institute for Health and Care Excellence (NICE) guidelines performed consistently well, scoring 100% in five of six domains; NICE was one of the few guidelines that specifically reported stakeholder involvement, scoring 97%. Generally, the domain of 'Stakeholder involvement' ranked poorly with seven of twelve guidelines scoring below 50%, with the worst score in this domain demonstrated by Danish guidelines at 25%.
Six of twelve guidelines (NICE, American Society of Colon & Rectal Surgeons (ASCRS), European Society of Coloproctology (ESCP), American Gastroenterological Association, German Society of Gastroenterology/German Society for General and Visceral Surgery (German), Netherlands Society of Surgery) scored above 70%. Only three, NICE, ASCRS and ESCP, scored above 75% and were voted unanimously by the appraisers for use as they are. Therefore, use of AGREE II may help improve the methodological quality of guidelines and their future updates.
憩室病是导致人们前往急诊部就诊和需要住院治疗的最常见原因之一。在过去十年中，许多外科和胃肠病学会已经发布了关于憩室病管理的指南。本研究的目的是使用评估指南研究和评估 II （AGREE II）工具评估这些指南的方法学质量。
系统地检索了 PubMed、Embase、Cochrane 图书馆和 Google Scholar 数据库。五位评估员使用 AGREE II 工具独立评估指南的方法学质量。
系统的文献检索确定了 12 项指南。所有指南的总体中位数评分为 68％。在所有指南中，“范围和目的”领域的最高评分为 85％。“清晰度和表述”和“编辑独立性”两个领域的中位数均为 72％。得分最低的是“利益相关者参与”和“适用性”领域，分别为 46％和 40％。总体而言，英国国家卫生与保健优化研究所（NICE）指南表现出色，在六个领域中的五个领域得分为 100％；NICE 是少数几个专门报告利益相关者参与情况的指南之一，得分为 97％。通常，“利益相关者参与”领域的得分较差，12 项指南中有 7 项得分低于 50％，其中丹麦指南在该领域的得分最低，为 25％。
12 项指南中有 6 项（NICE、美国结直肠外科医师学会（ASCRS）、欧洲结直肠外科学会（ESCP）、美国胃肠病协会、德国胃肠病学/德国普通和内脏外科学会（德国）、荷兰外科学会）的得分高于 70％。只有 NICE、ASCRS 和 ESCP 三项指南的得分高于 75％，并且得到了评估员的一致投票，建议将其作为参考。因此，使用 AGREE II 可能有助于提高指南的方法学质量，并对其未来的更新有所帮助。
