School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
National Institute of Health Data Science, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
J Clin Epidemiol. 2023 Sep;161:28-38. doi: 10.1016/j.jclinepi.2023.06.019. Epub 2023 Jul 4.
To appraise the methodological quality, clinical applicability, and reporting quality of clinical practice guidelines (CPGs) for frailty in primary care and identify research gaps using evidence mapping.
We conducted a systematic literature search in PubMed, Web of Science, Embase, CINAHL, guideline databases, and frailty or geriatric society websites. Appraisal of Guidelines Research and Evaluation II, AGREE-Recommendations Excellence, and Reporting Items for Practice Guidelines in Healthcare checklist were used to evaluate overall quality for frailty CPGs as "high", "medium", or "low" quality. We used bubble plots to show recommendations in CPGs.
Twelve CPGs were identified. According to the overall quality evaluation, five CPGs were considered as high quality, six as medium quality, and one as low quality. The recommendations in CPGs were generally consistent and mainly focused on frailty prevention, identification, multidisciplinary, nonpharmacological, and other treatments. However, evidence was lacking in some areas, such as effective prevention strategies and implementation of recommendations.
The frailty CPGs vary in quality but have consistent recommendations that can guide clinical practice in primary care. This could point the way for future research to address existing gaps and facilitate the development of trustworthy CPGs for frailty.
使用证据图谱评估初级保健中衰弱的临床实践指南(CPG)的方法学质量、临床适用性和报告质量,并确定研究空白。
我们在 PubMed、Web of Science、Embase、CINAHL、指南数据库和衰弱或老年学会网站上进行了系统文献检索。使用评估指南研究和评估 II、AGREE-推荐卓越和医疗保健实践指南报告项目清单来评估衰弱 CPG 的整体质量为“高”、“中”或“低”质量。我们使用气泡图显示 CPG 中的建议。
确定了 12 项 CPG。根据整体质量评估,有 5 项 CPG 被认为是高质量的,6 项是中等质量的,1 项是低质量的。CPG 中的建议通常是一致的,主要集中在衰弱预防、识别、多学科、非药物和其他治疗上。然而,在一些领域缺乏证据,例如有效的预防策略和建议的实施。
衰弱 CPG 的质量存在差异,但具有一致的建议,可以指导初级保健中的临床实践。这可能为未来的研究指明方向,以解决现有差距,并为衰弱制定值得信赖的 CPG。