Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States of America.
Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States of America; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
Am J Otolaryngol. 2022 Nov-Dec;43(6):103606. doi: 10.1016/j.amjoto.2022.103606. Epub 2022 Aug 13.
Medullary thyroid carcinoma (MTC) is a rare and aggressive form of thyroid neoplasia that requires multidisciplinary collaboration for effective management. We systematically appraise the quality of clinical practice guidelines (CPG) for the diagnosis and treatment of MTC using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.
A systematic literature search was performed to identify CPGs pertaining to the diagnosis and treatment of MTC. Data were abstracted from guidelines meeting inclusion criteria and appraised by four independent reviewers in the six domains of quality defined by the AGREE II. Intraclass correlation coefficients (ICC) were calculated across domains to qualify interrater reliability.
Fourteen guidelines met inclusion criteria. No guideline achieved a score of >60 % in five or more AGREE II quality domains, which is required to gain designation as 'high' quality. One "average quality" guideline authored by the British Thyroid Association achieved a score of >60 % in three quality domains. The remaining thirteen (92.9 %) CPGs demonstrated low quality content, with deficits most pronounced in domains 3, 5, and 6, suggesting a lack of rigorously developed, clinically applicable, and transparent information.
As the diagnosis and treatment of MTC continues to evolve, the development of high-quality guidelines becomes increasingly important; few existing meet appropriate standards.
髓样甲状腺癌（MTC）是一种罕见且侵袭性的甲状腺肿瘤，需要多学科合作才能进行有效管理。我们使用评估指南研究与评估（AGREE II）工具系统地评估了用于诊断和治疗 MTC 的临床实践指南（CPG）的质量。
进行了系统的文献检索，以确定与 MTC 的诊断和治疗相关的 CPG。从符合纳入标准的指南中提取数据，并由四位独立评审员在 AGREE II 定义的六个质量领域中进行评估。计算各领域的组内相关系数（ICC）以确定评分者间的可靠性。
有 14 条指南符合纳入标准。没有一条指南在五个或更多 AGREE II 质量领域中获得>60%的评分，这是被指定为“高质量”的要求。英国甲状腺协会撰写的一份“中等质量”指南在三个质量领域中获得了>60%的评分。其余十三份（92.9%）CPG 显示出低质量的内容，在第 3、5 和 6 个领域中存在明显的缺陷，表明缺乏经过严格制定、具有临床适用性和透明度的信息。
随着 MTC 的诊断和治疗不断发展，制定高质量的指南变得越来越重要；但目前很少有符合适当标准的指南。
