Department of Medicine, Hackensack Meridian Health Palisades Medical Center, 7600 River Road, North Bergen, NJ, 07047, USA.
Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA.
J Gastrointest Cancer. 2022 Sep;53(3):669-673. doi: 10.1007/s12029-021-00700-3. Epub 2021 Aug 31.
Little data is available surrounding societal recommendations regarding extra-colonic malignancy in patients with inflammatory bowel disease (IBD). As a result, we systematically analyzed these international guidelines to assess their overall quality as well as their adherence to standards for high-quality practice guidelines.
A systematic search was performed in multiple databases to identify all guidelines pertaining to extra-colonic malignancy in IBD in April 2020. All guidelines were reviewed for conflicts of interest (COI)/funding, recommendation quality and strength, external document review, use of patient representation, and plans for update-as per Institute of Medicine standards. In addition, recommendations were compared between guidelines/societies. Statistical analysis was conducted using R.
A total of 11 recommendations on extra-colonic malignancy in IBD were put forth by 5 guidelines/societies. Zero percent of recommendations were found to be based on high-quality evidence, 36.4% of recommendations on moderate-quality evidence, and 63.6% of recommendations on low-quality evidence. 9.1% were strong recommendations, 0% were weak/conditional recommendations, and 90.9% of recommendations did not provide a strength. No guideline included patient representation or had plans for future update of their recommendations.
There is a consistent lack of high-quality recommendations for extra-colonic malignancy in IBD across different societal guidelines. The need for high-quality studies to improve the strength of recommendations is eminent, as this will ultimately lead to high-quality patient care.
关于炎症性肠病（IBD）患者的结外恶性肿瘤，相关社会建议的数据较少。因此，我们系统地分析了这些国际指南，以评估其整体质量以及对高质量实践指南标准的遵循程度。
我们在多个数据库中进行了系统搜索，以确定 2020 年 4 月所有与 IBD 结外恶性肿瘤相关的指南。根据医学研究所的标准，对所有指南进行了利益冲突（COI）/资金、推荐质量和强度、外部文件审查、患者代表的使用以及更新计划的审查。此外，还对指南/学会之间的建议进行了比较。使用 R 进行了统计分析。
共有 5 个指南/学会提出了 11 条关于 IBD 结外恶性肿瘤的建议。没有一条建议是基于高质量证据的，36.4%的建议是基于中等质量证据的，63.6%的建议是基于低质量证据的。9.1%的建议是强推荐，0%的建议是弱/有条件的推荐，90.9%的建议没有提供推荐强度。没有指南包括患者代表或对其建议的未来更新有任何计划。
不同的社会指南对 IBD 结外恶性肿瘤的建议一致缺乏高质量的建议。需要高质量的研究来提高建议的强度，这将最终导致高质量的患者护理。
