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青少年和成人肥胖管理的循证指南中的建议差异:证据图谱

Discrepancies Between Recommendations in Evidence-Based Guidelines for the Management of Obesity in Adolescents and Adults: An Evidence Map.

作者信息

Brauchmann Jana, Laudenbach Luise, Kapp Philipp, Grummich Kathrin, Lischka Julia, Vanersa Nicole, Rocha Edrienny Patricia Alves Accioly, Ernst Gundula, Meerpohl Joerg J, Tannen Antje, Weghuber Daniel, Weihrauch-Blüher Susann, Wiegand Susanna, Torbahn Gabriel

机构信息

Department of Pediatric Endocrinology and Diabetology, Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin, Germany.

Department of Medical Psychology, Hannover Medical School, Hannover, Germany.

出版信息

Obes Rev. 2025 Oct;26(10):e13945. doi: 10.1111/obr.13945. Epub 2025 May 27.

Abstract

BACKGROUND/AIM: The aim of this evidence map is to provide a systematic overview of evidence-based guidelines for the management of obesity and to highlight discrepancies between recommendations for the pediatric and adult populations. Knowing about these discrepancies may be relevant during the transition from pediatrics to adult healthcare to enable a structured, successful transfer.

METHODS

We used two already existing guideline synopses of the Institute for Quality and Efficiency in Health Care as a basis and additionally searched Embase and Medline as well as guideline portals for creating a systematic overview of evidence-based pediatric and adult guidelines on obesity management. The quality of the identified guidelines was assessed using AGREE II.

RESULTS

Thirty-nine guidelines (published 08/2017 to 08/2023), containing 1248 recommendations, were included in the review and allocated to nine different healthcare categories. Discrepancies between the pediatric and adult populations were mainly identified in diagnostics and health behavior lifestyle treatment. Gaps were found in recommendations for bariatric surgery, pharmacotherapy, and emergency (-contraception).

CONCLUSION

The unique characteristics of adolescence are insufficiently addressed in current evidence-based guidelines. Therefore, healthcare professionals may benefit from considering the discrepancies and gaps identified in this review when providing recommendations during the transition of healthcare for this age group.

摘要

背景/目的:本证据图谱的目的是对肥胖管理的循证指南进行系统概述,并突出儿科和成人人群推荐意见之间的差异。了解这些差异在从儿科医疗向成人医疗过渡期间可能具有重要意义,以便实现结构化、成功的过渡。

方法

我们以医疗质量与效率研究所已有的两份指南概要为基础,另外检索了Embase、Medline以及指南门户网站,以创建关于肥胖管理的循证儿科和成人指南的系统概述。使用AGREE II评估所确定指南的质量。

结果

本综述纳入了39份指南(发布于2017年8月至2023年8月),包含1248条推荐意见,并分配到九个不同的医疗类别。儿科和成人人群之间的差异主要体现在诊断和健康行为生活方式治疗方面。在减肥手术、药物治疗和紧急避孕方面的推荐意见中发现了差距。

结论

当前的循证指南对青春期的独特特征关注不足。因此,医疗保健专业人员在为该年龄组提供医疗过渡期间的建议时,可能会受益于考虑本综述中确定的差异和差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/725c/12404892/fa785549146a/OBR-26-e13945-g002.jpg

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