Wei Lili, Shang Wenru, Nan Yaxing, Liu Yuming, Yang Jingyu, Yang Kehu
From the School of Business and Management, Gansu University of Traditional Chinese Medicine, Lanzhou, China (LW, YN, JY); Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China (WS, KY); and Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China (YL).
Am J Phys Med Rehabil. 2025 Feb 1;104(2):193-201. doi: 10.1097/PHM.0000000000002413. Epub 2024 Jan 3.
The purpose of this study was to provide an evidence map for explaining research trends and gaps. Four databases and clinical practice guidelines-related Websites were searched up to March 2022. Basic information, methodological quality, reporting quality of clinical practice guidelines, and similar stroke recommendations were extracted. The methodological and reporting quality of stroke clinical practice guidelines were evaluated using the Appraisal of Guidelines Research and Evaluation (second version) instrument and the Reporting Items for Practice Guidelines in Healthcare checklist. The bubble plot format of the evidence map helped visualize the overall quality. Data management and analysis were performed using Excel 2013 and SPSS 22.0 software. A total of 12 clinical practice guidelines, published between 1997 and 2020, were included for in-depth analysis. The identified clinical practice guidelines had a mixed quality and scored poorly in the developmental rigor and applicability domains by Appraisal of Guidelines Research and Evaluation (second version). According to the Reporting Items for Practice Guidelines in Healthcare checklist, field four (clarity of expression) showed the highest (79.2%), and field three (rigor of formulation) secured the lowest (28%) reporting rates. The stroke rehabilitation recommendations primarily focused on organizational management, timing and intensity, rehabilitation and nutritional management of dysphagia, return to work, communication, speech, and language function. This would promote improvement in developing trustworthy clinical practice guidelines for stroke rehabilitation.
本研究的目的是提供一份证据图谱，以解释研究趋势和差距。检索了四个数据库以及与临床实践指南相关的网站，检索截止至2022年3月。提取了临床实践指南的基本信息、方法学质量、报告质量以及类似的卒中建议。使用《指南研究与评价》（第二版）工具和《医疗保健实践指南报告条目》清单对卒中临床实践指南的方法学和报告质量进行评估。证据图谱的气泡图格式有助于直观呈现整体质量。使用Excel 2013和SPSS 22.0软件进行数据管理和分析。共纳入了1997年至2020年间发表的12份临床实践指南进行深入分析。经《指南研究与评价》（第二版）评估，所确定的临床实践指南质量参差不齐，在制定严谨性和适用性领域得分较低。根据《医疗保健实践指南报告条目》清单，第四领域（表达清晰度）的报告率最高（79.2%），第三领域（制定严谨性）的报告率最低（28%）。卒中康复建议主要集中在组织管理、时机和强度、吞咽困难的康复和营养管理、重返工作、沟通、言语和语言功能等方面。这将有助于改进制定可靠的卒中康复临床实践指南。
