School of Health and Related Research, University of Sheffield, Sheffield, UK.
NHS Foundation Trust, Sheffield Teaching Hospital, Sheffield, UK.
Colorectal Dis. 2022 Jun;24(6):764-772. doi: 10.1111/codi.16078. Epub 2022 Mar 2.
Guidelines benefit patients and clinicians by distilling evidence into easy-to-read recommendations. The literature around the management of haemorrhoids is immense and guidelines are invaluable to improve treatment integrity and patient outcomes. We identified current haemorrhoid guidelines and assessed them for quality and consistency.
A systematic search of the literature from January 2011 to October 2021 was carried out. Guidelines identified were assessed for quality using the AGREE II instrument and for consistency in terms of tabulated treatment recommendations.
During this period nine guidelines were identified worldwide. The general quality was poor with only one guideline considered of high enough quality for use. In general, expert selection criteria for guideline development groups were vaguely defined. There were inconsistencies in the interpretation of the published evidence leading to variation in treatment recommendations.
Fewer, higher quality guidelines, with more consistent results, are needed. Particular attention should be given to defining the selection of experts involved.
指南通过将证据提炼成易于阅读的建议，使患者和临床医生受益。痔管理相关文献浩如烟海，指南对于提高治疗完整性和患者结局至关重要。我们确定了当前的痔指南，并评估了它们的质量和一致性。
从 2011 年 1 月至 2021 年 10 月进行了系统的文献检索。使用 AGREE II 工具评估指南的质量，并评估表格化治疗建议的一致性。
在此期间，全球范围内确定了 9 项指南。总体质量较差，只有 1 项指南被认为质量足够高可供使用。通常情况下，指南制定小组的专家选择标准定义模糊。对已发表证据的解释不一致，导致治疗建议存在差异。
需要更少、更高质量的指南，并且结果更加一致。应特别注意定义所涉及的专家选择。
