评估和系统审查关于 status epilepticus 的指导文件
Yue Cao1, Hua Li1, Mingyue Chen2
1Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Epilepsy & behavior : E&B
|December 21, 2023
概括
治疗状态 (SE) 的指导文件质量各不相同,清晰度好,但编辑独立性差. 为了更好地基于证据的建议,方法论的严谨性需要改进.
科学领域:
- 神经学 神经学
- 临床实践指南 临床实践指南
- 基于证据的医学 基于证据的医学
背景情况:
- 准则文档对于管理 status epilepticus (SE) 是至关重要的.
- 现有的SE管理准则的方法质量尚未得到充分证实.
- 评估这些文件对于改善患者护理至关重要.
研究的目的:
- 系统地审查和评估SE管理的临床实践指南和共识声明的方法质量.
- 总结建议并确定SE指导文件中需要改进的领域.
主要方法:
- 对14个临床实践指南和11个共识陈述 (1993-2022) 的系统审查.
- 使用研究和评估指南评估II (AGREE II) 方法进行指南质量的评估.
- 关于SE管理的建议摘要.
主要成果:
- 陈述的清晰度一般很好 (中位数为71.8%),但编辑独立性被评为很差 (中位数为32.1%).
- 2016年美国病学会的指导方针获得了最高的整体得分.
- 在SE定义和诊断中一致,但治疗建议,特别是药物治疗时间的显著变化.
结论:
- 大多数SE指导文件都需要加强方法论的严格性,以提高标准化和参考价值.
- 建议中的差异表明需要解决的证据缺口.
- 迫切需要指导方针,包括这种紧急情况的医院前管理策略.
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