补充和替代医学在炎症性肠病指南中的提及和建议：使用 AGREE II 进行系统评价和评估。
Complementary and alternative medicine mention and recommendations in inflammatory bowel disease guidelines: systematic review and assessment using AGREE II.
机构信息
Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
出版信息
BMC Complement Med Ther. 2023 Jul 11;23(1):230. doi: 10.1186/s12906-023-04062-0.
BACKGROUND
Many patients with inflammatory bowel disease (IBD) use complementary and alternative medicine (CAM) for disease management. There is, however, a communication gap between patients and healthcare professionals regarding CAM use, where patients are hesitant to disclose CAM use to providers. The purpose of this study was to identify the quantity and assess the quality of CAM recommendations in IBD clinical practice guidelines (CPGs) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.
METHODS
MEDLINE, EMBASE, and CINAHL were systematically searched from 2011 to 2022 to find CPGs for the treatment and/or management of IBD. The Guidelines International Network (GIN) and National Center for Complementary and Integrative Health (NCCIH) websites were also searched. Eligible CPGs were assessed using the AGREE II instrument.
RESULTS
Nineteen CPGs made CAM recommendations for IBD and were included in this review. Average scaled domain percentages of CPGs were as follows (overall CPG, CAM section): scope and purpose (91.5%, 91.5%), clarity of presentation (90.3%, 64.0%), editorial independence (57.0%, 57.0%), stakeholder involvement (56.7%, 27.8%), rigour of development (54.7%, 45.9%), and applicability (14.6%, 2.1%).
CONCLUSIONS
The majority of CPGs with CAM recommendations were of low quality and their CAM sections scored substantially lower relative to other therapies in the overall CPG. In future updates, CPGs with low scaled-domain percentages could be improved in accordance with AGREE II and other guideline development resources. Further research investigating how CAM therapies can best be incorporated into IBD CPGs is warranted.
背景
许多炎症性肠病（IBD）患者使用补充和替代医学（CAM）来进行疾病管理。然而，患者和医疗保健专业人员在 CAM 使用方面存在沟通障碍，患者不愿向提供者透露 CAM 使用情况。本研究的目的是使用评估指南研究与评估 II（AGREE II）工具，确定 IBD 临床实践指南（CPG）中 CAM 建议的数量并评估其质量。
方法
从 2011 年到 2022 年，系统地在 MEDLINE、EMBASE 和 CINAHL 中搜索治疗和/或管理 IBD 的 CPG。还搜索了指南国际网络（GIN）和国家补充与综合健康中心（NCCIH）网站。使用 AGREE II 工具评估符合条件的 CPG。
结果
纳入了 19 项对 IBD 提出 CAM 建议的 CPG。CPG 的平均比例域百分比如下（总体 CPG，CAM 部分）：范围和目的（91.5%，91.5%），表述清晰度（90.3%，64.0%），编辑独立性（57.0%，57.0%），利益相关者参与（56.7%，27.8%），开发严谨性（54.7%，45.9%）和适用性（14.6%，2.1%）。
结论
大多数包含 CAM 建议的 CPG 质量较低，其 CAM 部分的得分相对于总体 CPG 中的其他疗法要低得多。在未来的更新中，根据 AGREE II 和其他指南制定资源，可以改进比例域百分比较低的 CPG。进一步研究如何将 CAM 疗法最好地纳入 IBD CPG 是有必要的。
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