Health Department, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, Mexico City 01219, Mexico.
Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, Mexico City 01219, Mexico.
Nutrients. 2022 Nov 1;14(21):4579. doi: 10.3390/nu14214579.
This work aimed to identify clinical practice guidelines (CPGs) that include recommendations for the prevention, diagnosis, and treatment of women’s malnutrition during pregnancy and to evaluate the quality of these guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. We conducted a literature review using PubMed and different websites from January 2009 to February 2021. The quality of the CPGs was independently assessed by reviewers using the AGREE II instrument, which defines guidelines scoring >70% in the overall assessment as “high quality”. The analysis included 43 guidelines. Among the main findings, we identified that only half of the CPGs (51.1%) obtained a final “high quality” evaluation. AGREE II results varied widely across domains and categories. The two domains that obtained the highest scores were scope and purpose with 88.3% (range 39 to 100%) and clarity of presentation with 87.2% (range 25 to 100%). Among the “high quality” CPGs, the best scores were achieved by the three guidelines published by the National Institute of Health and Care Excellence (NICE) and the World Health Organization (WHO). Due to the importance of maternal nutrition in pregnancy, it is essential to join forces to improve the quality of the guidelines, especially in CPGs that do not meet the reference standards for quality.
本研究旨在确定包含孕妇营养不良预防、诊断和治疗建议的临床实践指南（CPG），并使用评估指南研究与评估工具（AGREE II）评估这些指南的质量。我们于 2009 年 1 月至 2021 年 2 月，通过 PubMed 和其他不同网站进行了文献检索。两名评审员独立使用 AGREE II 工具评估 CPG 质量，将总体评估得分>70%的指南定义为“高质量”。分析共纳入 43 项指南。主要发现包括，仅有一半的 CPG（51.1%）获得最终“高质量”评价。AGREE II 结果在各领域和类别间差异较大。范围和目的维度得分最高，为 88.3%（范围为 39%至 100%），表述清晰度维度得分为 87.2%（范围为 25%至 100%）。在“高质量”指南中，英国国家卫生与保健优化研究所（NICE）和世界卫生组织（WHO）发布的 3 项指南得分最高。鉴于妊娠期间孕产妇营养的重要性，必须共同努力提高指南质量，尤其是在不符合质量参考标准的 CPG 中。
