Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.
Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.
BMC Oral Health. 2023 Sep 30;23(1):704. doi: 10.1186/s12903-023-03409-w.
The prevalence and consequences of traumatic dental injuries (TDI) make them a public health problem. Trustworthy TDI clinical practice guidelines (CPGs) assist clinicians in determining a diagnosis and guide them to the most appropriate therapy. The aim of this systematic survey was to identify and evaluate the quality of CPGs for the diagnosis, emergency management, and follow-up of TDIs.
A systematic search was carried out in MEDLINE, EMBASE, Epistemonikos, Trip database, CPG websites, and dental societies to identify documents providing recommendations for the emergency and sequelae management of TDIs. Reviewers assessed the included guidelines independently and in duplicate, using the AGREE II instrument. ANOVA or Student's t-tests were used to determine the attributes of CPGs associated with the total score in AGREE II.
Ten CPGs published between 2010 and 2020 were included, mostly from Europe (n = 6). The overall agreement between reviewers was very good (0.94; 95%CI 0.91-0.97). The mean scores (the higher the score, the better the domain assessment) per domain were as follows: Scope and purpose 78.0 ± 18.9%; stakeholder involvement 46.9 ± 29.6%; rigour of development 41.8 ± 26.7%; clarity of presentation 75.8 ± 17.6%; applicability 15.3 ± 18.8%; and editorial independence 41.7 ± 41.7%. The overall mean rate was 4 ± 1.3 out of a maximum score of 7. Two guidelines were recommended by the reviewers for use in practice and rated as high quality. CPGs developed by government organizations showed a significantly higher overall score.
The overall quality of CPGs on TDI was suboptimal. CPG developers should synthesize the evidence and formulate recommendations using high-quality methodologies and standards in a structured, transparent, and explicit way.
创伤性牙外伤(TDI)的流行率和后果使其成为一个公共卫生问题。可靠的 TDI 临床实践指南(CPG)可帮助临床医生确定诊断,并指导他们选择最合适的治疗方法。本系统调查的目的是确定和评估 TDI 的诊断、急症管理和随访的 CPG 的质量。
系统检索 MEDLINE、EMBASE、Epistemonikos、Trip 数据库、CPG 网站和牙科协会,以确定提供 TDI 急症和后遗症管理建议的文件。审查员使用 AGREE II 工具独立和重复评估纳入的指南。使用方差分析或学生 t 检验确定与 AGREE II 总分相关的 CPG 属性。
纳入了 2010 年至 2020 年期间发表的 10 项 CPG,主要来自欧洲(n=6)。审查员之间的总体一致性非常好(0.94;95%CI 0.91-0.97)。每个域的平均得分(得分越高,域评估越好)如下:范围和目的 78.0±18.9%;利益相关者参与 46.9±29.6%;制定的严谨性 41.8±26.7%;表述的清晰度 75.8±17.6%;适用性 15.3±18.8%;和编辑独立性 41.7±41.7%。总分为 7 分,平均得分为 4±1.3 分。有 2 项指南被审查员推荐用于实践,并被评为高质量。由政府组织制定的 CPG 显示出更高的总体评分。
TDI 的 CPG 总体质量不理想。CPG 开发者应使用高质量的方法和标准,以结构化、透明和明确的方式综合证据并制定建议。