Division of General Surgery, McMaster University, Hamilton, ON, Canada.
Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
Int J Obes (Lond). 2024 Sep;48(9):1193-1204. doi: 10.1038/s41366-024-01559-7. Epub 2024 Jun 18.
In recent years, multiple guidelines on bariatric and metabolic surgery were published, however, their quality remains unknown, leaving providers with uncertainty when using them to make perioperative decisions. This study aims to evaluate the quality of existing guidelines for perioperative bariatric surgery care.
A comprehensive search of MEDLINE and EMBASE were conducted from January 2010 to October 2022 for bariatric clinical practice guidelines. Guideline evaluation was carried out using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) framework.
The initial search yielded 1483 citations, of which, 26 were included in final analysis. The overall median domain scores for guidelines were: (1) scope and purpose: 87.5% (IQR: 57-94%), (2) stakeholder involvement: 49% (IQR: 40-64%), (3) rigor of development: 42.5% (IQR: 22-68%), (4) clarity of presentation: 85% (IQR: 81-90%), (5) applicability: 6% (IQR: 3-16%), (6) editorial independence: 50% (IQR: 48-67%), (7) overall impressions: 48% (IQR: 33-67%). Only six guidelines achieved an overall score >70%.
Bariatric surgery guidelines effectively outlined their aim and presented recommendations. However, many did not adequately seek patient input, state search criteria, use evidence rating tools, and consider resource implications. Future guidelines should reference the AGREE II framework in study design.
近年来，发布了多项关于减重和代谢手术的指南，但它们的质量仍然未知，这使得提供者在使用这些指南做出围手术期决策时存在不确定性。本研究旨在评估现有的减重手术围手术期护理指南的质量。
从 2010 年 1 月至 2022 年 10 月，对 MEDLINE 和 EMBASE 进行了全面检索，以获取减重临床实践指南。使用评估指南研究和评估 II（AGREE II）框架对指南进行评估。
最初的搜索产生了 1483 条引文，其中 26 条被纳入最终分析。指南的总体中位数领域得分如下：（1）范围和目的：87.5%（IQR：57-94%），（2）利益相关者参与：49%（IQR：40-64%），（3）开发的严谨性：42.5%（IQR：22-68%），（4）表达的清晰度：85%（IQR：81-90%），（5）适用性：6%（IQR：3-16%），（6）编辑独立性：50%（IQR：48-67%），（7）总体印象：48%（IQR：33-67%）。只有 6 项指南的总体得分>70%。
减重手术指南有效地概述了他们的目标并提出了建议。然而，许多指南没有充分征求患者意见、说明检索标准、使用证据评级工具以及考虑资源影响。未来的指南应在研究设计中参考 AGREE II 框架。
