Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
Eur Spine J. 2022 Oct;31(10):2650-2663. doi: 10.1007/s00586-022-07288-7. Epub 2022 Jul 23.
Individuals with neck pain frequently turn to complementary and alternative medicine (CAM) to seek relief. However, conventional healthcare providers often lack adequate CAM therapy knowledge to deliver informed recommendations to patients. The purpose of this study was to identify mention of CAM in neck pain clinical practice guidelines (CPG) and assess the quality of CAM recommendations using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument.
MEDLINE, EMBASE and CINAHL were systematically searched from 2009 to 2020 in addition to the Guidelines International Network and National Center for Complementary and Integrative Health websites. Eligible CPGs providing CAM recommendations were assessed twice with the AGREE II instrument, once to assess the overall CPG and then once to assess the CAM sections specifically.
From 643 unique search results, 15 CPGs on the treatment and/or management of neck pain were identified, and 8 made recommendations on CAM therapy. Regarding scaled domain percentages, the overall CPG scored higher than the CAM section for 5 of 6 domains (overall, CAM): (1) scope and purpose (93.4%, 93.1%), (2) stakeholder involvement (81.6%, 81.9%), (3) rigour of development (70.8%, 66.3%), (4) clarity of presentation (64.9%, 60.8%), (5) applicability (39.3%, 33.6%), and (6) editorial independence (47.9%, 45.3%).
Most neck pain CPGs made CAM recommendations. The quality of CAM recommendations is lower than overall recommendations across all domains with the exception of stakeholder involvement. This disparity highlights the need for CAM recommendations quality improvement. Although many patients with neck pain seek CAM therapies, few CPGs are available for healthcare providers and patients.
患有颈痛的个体经常寻求补充和替代医学（CAM）来寻求缓解。然而，传统的医疗保健提供者通常缺乏足够的 CAM 治疗知识，无法向患者提供明智的建议。本研究的目的是确定颈痛临床实践指南（CPG）中 CAM 的提及，并使用评估研究和评估工具 II（AGREE II）评估 CAM 建议的质量。
从 2009 年到 2020 年，系统地在 MEDLINE、EMBASE 和 CINAHL 中进行了搜索，此外还在指南国际网络和国家补充和综合健康中心网站上进行了搜索。评估了提供 CAM 建议的合格 CPG 两次，一次评估总体 CPG，然后一次评估 CAM 部分。
从 643 个独特的搜索结果中，确定了 15 项关于颈痛治疗和/或管理的 CPG，其中 8 项提出了关于 CAM 治疗的建议。关于比例域百分比，总体 CPG 在 6 个域中的 5 个域（总体，CAM）的得分高于 CAM 部分：（1）范围和目的（93.4%，93.1%），（2）利益相关者参与（81.6%，81.9%），（3）发展严谨性（70.8%，66.3%），（4）表述清晰度（64.9%，60.8%），（5）适用性（39.3%，33.6%）和（6）编辑独立性（47.9%，45.3%）。
大多数颈痛 CPG 都提出了 CAM 建议。CAM 建议的质量低于所有领域的总体建议，除了利益相关者的参与。这种差距突出表明需要改进 CAM 建议的质量。尽管许多患有颈痛的患者寻求 CAM 疗法，但很少有 CPG 可供医疗保健提供者和患者使用。
