Guo L W, Li J, Chen Y M, Liu Y, Li H, Cao M M, He S Y, Zhang S K, Chen W Q
Henan Office for Cancer Control and Research, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, The Affiliated Cancer Hospital of Zhengzhou University, Henan Provincial Cancer Hospital, Zhengzhou 450008, China.
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Jul 10;42(7):1318-1324. doi: 10.3760/cma.j.cn112338-20200805-01023.
To systematically evaluate the methodological quality of screening guidelines for upper gastrointestinal cancer (including esophageal cancer and gastric cancer) both at home and abroad, and provide reference for the update of upper gastrointestinal cancer screening guidelines in China. Original articles and grey literature published as of 31 Aug 2020 were retrieved using Chinese databases (CNKI, Wanfang, China Biomedical Literature Database and China Guideline Clearinghouse), PubMed, The Cochrane Library and Embase, as well as those from International Agency for Research on Cancer and the International Guide Collaboration Network. The inclusion criteria were being independent guidelines/recommendation documents for upper gastrointestinal cancer screening and meeting the definition of the institute of Medicine, USA. The exclusion criteria were being guideline abstracts, interpretation and evaluation literature, duplicate publications, updated original guidelines, and clinical treatment or practice guidelines for esophageal or gastric cancer. Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) were used to compare and evaluate the quality and reporting standard of esophageal or gastric cancer screening guidelines. A total of 6 esophageal cancer screening guidelines and 5 gastric cancer screening guidelines were included. The results of the AGREE Ⅱ quality evaluation showed that the overall quality of eleven guidelines varied, including two guidelines recommended for "A", one for "B", five for "C" and three for "D". The guidelines had higher scores in the areas of scope and purpose, and clarity. The esophageal cancer screening guidelines had different scores in the areas of rigor and independence. The gastric cancer screening guidelines generally had low scores in the areas of participants and application. The RIGHT evaluation results showed that the quality of eleven guidelines should be improved. The six items with poor report quality were background, evidence, recommendations, review and quality assurance, funding and conflict of interest statement and management and others. The quality of the included upper gastrointestinal cancer screening guidelines is general, and the standardization needs to be strengthened.
系统评价国内外上消化道癌（包括食管癌和胃癌）筛查指南的方法学质量，为我国上消化道癌筛查指南的更新提供参考。通过中国数据库（知网、万方、中国生物医学文献数据库和中国指南库）、PubMed、Cochrane图书馆、Embase以及国际癌症研究机构和国际指南协作网络检索截至2020年8月31日发表的原始文章和灰色文献。纳入标准为上消化道癌筛查的独立指南/推荐文件且符合美国医学研究所的定义。排除标准为指南摘要、解读与评价文献、重复发表文献、更新的原始指南以及食管癌或胃癌的临床治疗或实践指南。采用指南研究与评价工具（AGREEⅡ）和医疗保健实践指南报告条目（RIGHT）对食管癌或胃癌筛查指南的质量和报告规范进行比较和评价。共纳入6篇食管癌筛查指南和5篇胃癌筛查指南。AGREEⅡ质量评价结果显示，11篇指南的整体质量参差不齐，其中2篇指南推荐等级为“A”，1篇为“B”，5篇为“C”，3篇为“D”。指南在范围与目的、清晰度等方面得分较高。食管癌筛查指南在严谨性和独立性方面得分各异。胃癌筛查指南在参与人员和应用方面得分普遍较低。RIGHT评价结果显示，11篇指南的质量有待提高。报告质量较差的6个项目为背景、证据、推荐意见、审查与质量保证、资金与利益冲突声明以及管理与其他方面。纳入的上消化道癌筛查指南质量总体一般，标准化有待加强。
