就儿童自闭症谱系障碍临床实践指南达成共识：一项系统评价与质量评估
AGREEing on Clinical Practice Guidelines for Autism Spectrum Disorders in Children: A Systematic Review and Quality Assessment.
作者信息
Amer Yasser S, Alenezi Shuliweeh, Bashiri Fahad A, Alawami Amel Hussain, Alhazmi Ayman Shawqi, Aladamawi Somayyah A, Alnemary Faisal, Alqahtani Yasser, Buraik Maysaa W, AlSuwailem Saleh S, Akhalifah Shahad M, Augusta de Souza Pinhel Marcela, Penner Melanie, Elmalky Ahmed M
机构信息
Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, Riyadh 11451, Saudi Arabia.
Clinical Practice Guidelines and Quality Research Unit, Quality Management Department, King Saud University Medical City, Riyadh 11451, Saudi Arabia.
出版信息
Children (Basel). 2022 Jul 14;9(7):1050. doi: 10.3390/children9071050.
BACKGROUND
Autism spectrum disorder (ASD) is a multifaceted neurodevelopmental disorder requiring multimodal intervention and an army of multidisciplinary teams for a proper rehabilitation plan. Accordingly, multiple practice guidelines have been published for different disciplines. However, systematic evidence to detect and intervene must be updated regularly. Our main objective is to compare and summarize the recommendations made in the clinical practice guidelines (CPGs) for ASD in children released from November 2015 to March 2022.
METHODS
CPGs were subjected to a systematic review. We developed the inclusion and exclusion criteria and health-related questions, then searched and screened for CPGs utilizing bibliographic and CPG databases. Each of the CPGs used in the study were critically evaluated using the Appraisal of Guidelines for REsearch and Evaluation II (AGREE II) instrument. In a realistic comparison table, we summarized the recommendations.
RESULTS
Four eligible CPGs were appraised: Australian Autism CRC (ACRC); Ministry of Health New Zealand (NZ); National Institute for Health and Care Excellence (NICE); and Scottish Intercollegiate Guidelines Network, Healthcare Improvement Scotland (SIGN-HIS). The overall assessments of all four CPGs scored greater than 80%; these findings were consistent with the high scores in the six domains of AGREE II, including: (1) scope and purpose, (2) stakeholder involvement, (3) rigor of development, (4) clarity of presentation, (5) applicability, and (6) editorial independence domains. Domain (3) scored 84%, 93%, 86%, and 85%; domain (5) 92%, 89%, 54%, and 85%; and domain (6) 92%, 96%, 88%, and 92% for ACRC, NICE, NZ, and SIGN-HIS, respectively. Overall, there were no serious conflicts between the clinical recommendations of the four CPGs, but some were more comprehensive and elaborative than others.
CONCLUSIONS
All four assessed evidence-based CPGs demonstrated high methodological quality and relevance for use in practice.
背景
自闭症谱系障碍（ASD）是一种多方面的神经发育障碍，需要多模式干预以及众多多学科团队制定适当的康复计划。因此，针对不同学科已经发布了多项实践指南。然而，用于检测和干预的系统证据必须定期更新。我们的主要目标是比较和总结2015年11月至2022年3月发布的关于儿童ASD的临床实践指南（CPG）中的建议。
方法
对CPG进行系统评价。我们制定了纳入和排除标准以及与健康相关的问题，然后利用书目数据库和CPG数据库搜索和筛选CPG。使用《研究与评价指南评估II》（AGREE II）工具对研究中使用的每个CPG进行严格评估。在一个实际比较表中，我们总结了这些建议。
结果
对四项合格的CPG进行了评估：澳大利亚自闭症合作研究中心（ACRC）；新西兰卫生部（NZ）；英国国家卫生与临床优化研究所（NICE）；以及苏格兰校际指南网络、苏格兰医疗保健改善局（SIGN-HIS）。所有四项CPG的总体评估得分均超过80%；这些结果与AGREE II六个领域的高分一致，包括：（1）范围和目的，（2）利益相关者参与，（3）制定的严谨性，（4）表述的清晰度，（5）适用性，以及（6）编辑独立性领域。领域（3）的得分分别为84%、93%、86%和85%；领域（5）分别为92%、89%、54%和85%；领域（6）分别为92%、96%、88%和92%，分别对应ACRC、NICE、NZ和SIGN-HIS。总体而言，四项CPG的临床建议之间没有严重冲突，但有些建议比其他建议更全面、更详尽。
结论
所有四项经过评估的循证CPG都显示出较高的方法学质量和在实践中使用的相关性。
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