専門学会によって開発された実践ガイドライン: 批判的評価の必要性
1Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. webmaster@assr.it
Lancet (London, England)
|February 16, 2000
まとめ
専門学会からの実践ガイドラインのほとんどは,ステークホルダーの関与,証拠の検索,または明示的な推奨の格付けを報告する報告が少ないが,品質が欠けている. 改善は認められていますが,全体的な品質は依然として満足のいくものではありません.
科学分野:
- 医療ガイドライン開発
- 医療サービス 研究 医療サービス
- 根拠に基づいた医学は,エビデンスに基づいた医療です.
背景:
- 医療実践ガイドラインの品質,信頼性,独立性に関する懸念が高まっている.
- 専門学会によって開発されたガイドラインの方法論的質に関するデータの欠如.
研究 の 目的:
- 専門学会によって開発された実践ガイドラインの方法論的質を調査し,評価する.
- ガイドライン開発プロセスにおける一般的な欠陥を特定する.
主な方法:
- 専門学会の実践ガイドラインの体系的なレビューは,ピアレビュー雑誌 (1988年-1998年) で発表された.
- 利害関係者の関与に関する報告,証拠探求戦略,勧告の明示的な格付けに基づくガイドラインの質の評価.
主要な成果:
- 431のガイドラインが評価され,そのほとんどは品質基準を満たさなかった.
- 利害関係者の関与 (67%),証拠調査 (88%),勧告の格付け (82%) について報告しない割合が高い.
- 検索と格付けは時間の経過とともに改善がみられたが,品質の3つの基準を満たしたのはわずか5%だった.
結論:
- 専門学会からの実践ガイドラインは,いくつかの改善にもかかわらず,不満足な方法論的品質を示しています.
- ガイドラインの開発には,共有された明示的な方法論的基準と共通の報告基準が必要である.
- ガイドラインの質を改善するために,CONSORTの声明に似た規格の促進が推奨されています.
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