Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2024 Jan;170(1):112-121. doi: 10.1002/ohn.466. Epub 2023 Aug 4.
Management of the difficult airway can be a challenging process, which necessitates actionable recommendations from well-established guidelines. Herein, clinical practice guideline (CPG) quality is evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.
A systematic literature search was performed using Scopus, EMBASE, and MEDLINE via PubMed.
Literature database.
Data were abstracted from relevant guidelines and appraised by 4 expert reviewers in the 6 domains of quality defined by AGREE II. Intraclass correlation coefficients (ICC) were calculated across domains to quantify interrater reliability.
Twelve guidelines met the inclusion criteria. With a mean quality score of 83.1%, the highest quality guideline was authored by the American Society of Anesthesiologists (ASA). Low-quality content was observed in CPGs authored by the Japanese Society of Anesthesiologists (JSA) and the Chinese Collaboration Group for Emergency Airway Management (CCGEAM). Overall, deficits were most pronounced in domains describing the involvement of stakeholders, developmental rigor, and editorial independence. These findings were consistent among the panel of independent reviewers, with high ICC inter-rater reliability scores of 58.0% to 70.0% for the referenced domains.
By providing a comprehensive appraisal of guidelines, this report may serve as a reference for clinicians seeking to understand and improve upon the developmental quality of difficult airway management resources. According to AGREE II criteria for the quality of the guideline creation process, the 2022 ASA guideline outperforms its predecessors.
困难气道的管理可能是一个具有挑战性的过程，这需要从既定的指南中获得可行的建议。在此，使用评估指南研究与评价（AGREE II）工具来评估临床实践指南（CPG）的质量。
通过 Scopus、EMBASE 和 MEDLINE 经 PubMed 进行系统文献检索。
文献数据库。
从相关指南中提取数据，并由 4 位专家评审员在 AGREE II 定义的 6 个质量领域进行评估。计算各领域的组内相关系数（ICC），以量化评分者间的可靠性。
符合纳入标准的指南有 12 条。美国麻醉师学会（ASA）撰写的指南质量最高，平均得分为 83.1%。日本麻醉师学会（JSA）和中国急救气道管理协作组（CCGEAM）撰写的指南质量较差。总体而言，在涉及利益相关者参与、发展严谨性和编辑独立性的领域，内容缺陷最为明显。这些发现与独立评审小组一致，参考领域的 ICC 评分者间可靠性得分在 58.0%至 70.0%之间。
通过对指南进行全面评估，本报告可为寻求了解和改进困难气道管理资源开发质量的临床医生提供参考。根据 AGREE II 指南制定过程质量的标准，2022 年 ASA 指南优于其前身。
