Ng Jeremy Y, Bhatt Hardil Anup, Raja Maheen
Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Integr Med Res. 2023 Mar;12(1):100921. doi: 10.1016/j.imr.2023.100921. Epub 2023 Jan 5.
Pancreatic cancer is the third leading cause of cancer death in the United States, which is attributed to limited treatment options. Complementary and alternative medicine (CAM) therapies have been proposed to provide benefits in treating pancreatic cancer. Despite its importance in treatment, clinicians are not generally well equipped to counsel their patients about CAM therapies. This review identified the quantity and assessed the quality of clinical practice guidelines (CPGs) providing CAM recommendations for the treatment and/or management of pancreatic cancer.
A systematic review was conducted to identify pancreatic cancer CPGs. MEDLINE, EMBASE and CINAHL were searched from 2011 to 2022. The Guidelines International Network (GIN) and the National Center for Complementary and Integrative Health (NCCIH) websites were also searched. Eligible CPGs published by non-profit agencies on treatment and/or management of pancreatic cancer for adults were assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument.
From 31 eligible search results, 7 CPGs mentioned CAM and 3 CPGs made CAM recommendations. The mean scaled domain percentages of the CPGs in this study (overall, CAM-specific) were as follows: scope and purpose (81.3%, 77.8%), stakeholder involvement (63.9%, 42.6%), rigor-of-development (51.0%, 40.3%), clarity-of-presentation (83.3%, 54.6%), applicability (42.3%, 30.5%), and editorial independence (58.3%, 58.3%).
Evaluation of the CPGs demonstrated that quality varied both within and between CPGs. CPGs that scored well could be used by patients and clinicians as the basis for discussion for the use of CAM therapies. Future research should identify other appropriate CAM therapies for further development of CPGs for pancreatic cancer.
The protocol was registered on PROSPERO (registration number: CRD42022334025).
胰腺癌是美国癌症死亡的第三大主要原因，这归因于治疗选择有限。补充和替代医学（CAM）疗法已被提议在治疗胰腺癌方面提供益处。尽管其在治疗中很重要，但临床医生通常没有充分的能力就CAM疗法向患者提供咨询。本综述确定了为胰腺癌的治疗和/或管理提供CAM建议的临床实践指南（CPG）的数量，并评估了其质量。
进行了一项系统综述以识别胰腺癌CPG。检索了2011年至2022年的MEDLINE、EMBASE和CINAHL。还搜索了指南国际网络（GIN）和国家补充与综合健康中心（NCCIH）的网站。使用《指南研究与评价II》（AGREE II）工具对非营利机构发布的关于成人胰腺癌治疗和/或管理的合格CPG进行评估。
从31个合格的搜索结果中，7个CPG提到了CAM，3个CPG提出了CAM建议。本研究中CPG的平均领域评分百分比（总体，特定于CAM）如下：范围和目的（81.3%，77.8%）、利益相关者参与（63.9%，42.6%）、制定的严谨性（51.0%，40.3%）、表述的清晰度（83.3%，54.6%）、适用性（42.3%，30.5%）和编辑独立性（58.3%，58.3%）。
对CPG的评估表明，CPG内部和之间的质量各不相同。得分较高的CPG可被患者和临床医生用作讨论使用CAM疗法的基础。未来的研究应确定其他合适的CAM疗法，以进一步制定胰腺癌的CPG。
该方案已在PROSPERO上注册（注册号：CRD42022334025）。
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