Department of Optometry and Visual Science, City, University of London, London, UK.
Ophthalmic Physiol Opt. 2024 Sep;44(6):1162-1187. doi: 10.1111/opo.13358. Epub 2024 Jul 31.
This study aimed to identify clinical guidelines that provide recommendations on prescribing refractive error correction in children, evaluate the overall quality of these guidelines using the Appraisal of Guidelines for REsearch and Evaluation II (AGREE II) tool and subsequently gain consensus on the prescribing recommendations from high-quality guidelines using the modified Delphi technique.
A comprehensive search for prescribing guidelines was conducted using databases and professional websites. The quality appraisal of eligible guidelines was undertaken by scoring the six AGREE II domains. Subsequently, the modified Delphi technique was used by 10 experts (sub-specialist optometrists, ophthalmologists and orthoptists) to gain consensus on the prescribing recommendation statements extracted from guidelines that had been identified as high quality. Three rounds were conducted in which agreement of these statements were scored using a 9-point Likert scale with a free-text option for any additional comments.
Five eligible guidelines were identified. The AGREE II tool demonstrated that the guidelines varied substantially in quality, with only one guideline identified as being of high quality. A total of 168 prescribing statements were reviewed in the Delphi procedure. Of these, 95 statements reached expert consensus as being appropriate prescribing recommendations.
There is significant scope for improving current guidelines for prescribing refractive error correction in children. We used the modified Delphi technique to find points of agreement on prescribing recommendations to support professionals prescribing refractive error correction in children. We recommend that further work is needed to address gaps in the guidelines.
本研究旨在确定提供儿童屈光不正矫正处方建议的临床指南，使用评估研究和评估指南 II（AGREE II）工具评估这些指南的总体质量，并随后使用改良 Delphi 技术对高质量指南中的处方建议达成共识。
使用数据库和专业网站全面搜索处方指南。通过对 AGREE II 六个领域的评分来评估合格指南的质量。随后，由 10 名专家（专科视光师、眼科医生和斜视矫正医生）使用改良 Delphi 技术对从高质量指南中确定的处方建议陈述达成共识。进行了三轮，使用 9 点 Likert 量表对这些陈述的一致性进行评分，并提供了任何其他评论的自由文本选项。
确定了 5 项合格指南。AGREE II 工具表明，指南在质量上存在很大差异，只有一项指南被确定为高质量。在 Delphi 程序中审查了总共 168 条处方陈述。其中，95 条陈述达成了专业共识，认为这是适当的处方建议。
目前有很大的空间可以改进儿童屈光不正矫正处方指南。我们使用改良 Delphi 技术找到了在处方建议上达成一致的要点，以支持专业人员为儿童开具屈光不正矫正处方。我们建议需要进一步解决指南中的差距。
