Soon William C L, Ng Yvonne, Seow Daniel, Jones Arwel W, Khor Yet H
Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Victoria, Australia.
Monash Lung Sleep Allergy Immunology, Monash Health, Melbourne, Victoria, Australia.
Intern Med J. 2025 Aug;55(8):1367-1376. doi: 10.1111/imj.70090. Epub 2025 Jun 19.
The Thoracic Society of Australia and New Zealand (TSANZ) is the leading Australasian professional society for respiratory medicine that develops clinical practice guidelines and position papers to advance lung health through improved clinical care and research efforts. Published TSANZ clinical guidance documents were identified from the online society repository until March 2023. Each document was independently scored using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklists for methodological and reporting quality respectively. Twenty-eight position papers and seven clinical practice guidelines were evaluated. The median overall methodological quality score for the AGREE II checklist was four out of a maximum of seven (interquartile range (IQR) 3.5-4.75). The majority of documents (97%) were recommended for use with or without modifications. The median overall reporting rate using the RIGHT checklist was 46% (IQR 40-54). Low-scoring items were rigour of evidence synthesis, focus on clinical implementation, conflict of interest declaration and clarity of methodology. Clinical practice guidelines scored significantly higher overall reporting quality than position papers (57% vs. 43%, P = 0.05), but not for the methodological quality scores (median number of high-scoring domains (>70%): 2 vs. 1, P = 0.13). Documents developed with methodologist involvement had significantly increased reporting (71% vs. 43%, P = 0.02) and methodological quality (median high-scoring domains: 4 vs. 1, P = 0.007), compared to those without. Based on AGREE II, most TSANZ clinical guidance documents are recommended for use, or for use with modifications. Applicability, stakeholder involvement and conflict of interest declarations are identified as areas for improvement in future documents.
澳大利亚和新西兰胸科学会（TSANZ）是澳大利亚和新西兰领先的呼吸医学专业学会，通过改善临床护理和研究工作来制定临床实践指南和立场文件，以促进肺部健康。截至2023年3月，从该学会的在线资料库中识别出已发布的TSANZ临床指导文件。每份文件分别使用《研究与评价指南II》（AGREE II）和《医疗卫生实践指南报告条目》（RIGHT）清单，对方法学质量和报告质量进行独立评分。共评估了28份立场文件和7份临床实践指南。AGREE II清单的总体方法学质量得分中位数为7分制中的4分（四分位间距（IQR）3.5 - 4.75）。大多数文件（97%）被建议使用，可作修改或不作修改。使用RIGHT清单的总体报告率中位数为46%（IQR 40 - 54）。得分较低的项目包括证据综合的严谨性、对临床实施的关注、利益冲突声明以及方法学的清晰度。临床实践指南的总体报告质量得分显著高于立场文件（57%对43%，P = 0.05），但在方法学质量得分方面并非如此（高分域（>70%）的中位数：2对1，P = 0.13）。与未由方法学家参与制定的文件相比，有方法学家参与制定的文件报告率显著提高（71%对43%，P = 0.02），方法学质量也更高（高分域中位数：4对1，P = 0.007）。基于AGREE II，大多数TSANZ临床指导文件被建议使用，或经修改后使用。适用性、利益相关者参与度和利益冲突声明被确定为未来文件中需要改进的领域。
