临床实践指南和指南评估研究中的质量问题:我们应该容忍还是消除?
Guo-Xun Yang1, Shu-Qian Dou2, Xiao-Bo Liu1
1The First Affiliated Hospital of Dali University, Dali, Yunnan, China.
Journal of evaluation in clinical practice
|October 30, 2024
概括
研究和评估指南评估II (AGREE II) 工具显示,临床实践指南的质量正在提高. 然而,诸如适用性 (Domain 5) 等特定领域仍然很低,这表明了开发人员关注的领域.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床流行病学 临床流行病学
- 准则的制定和评估.
背景情况:
- 研究和评价指南评估II (AGREE II) 是全球公认的评估临床实践指南 (CPG) 方法质量的工具.
- 之前的评估表明,CPG的质量存在差异,因此需要通过AGREE II工具集中审查常见的弱点和评估者挑战.
研究的目的:
- 确定在AGREE II对CPG的评估中经常得分低的领域和项目.
- 系统地审查使用AGREE II工具进行CG质量评估的评估员所遇到的挑战.
主要方法:
- 在医学数据库中进行了系统的文献搜索,对2022年至2023年之间发表的关于AGREE II在CPG评估中的使用研究进行了系统的文学搜索.
- 从2081个CPG中提取了六个质量领域和整体质量评分的数据,并使用描述性统计,差异分析,回归和相关性进行了分析.
- 包含的文章的报道质量使用七点的利克特度量表进行评估.
主要成果:
- 回归分析显示,所有领域都显著影响了总体指南质量 (p < 0.001;R2 = 0.777).
- 域1,2,3,4和6的得分随着时间的推移显著改善 (p < 0.001). 域4和域1表现出良好的分数,而域6,域2和域3有通用分数.
- 域5 (适用性) 获得了较低的分数 (中位数为36.20 [IQR: 20.20-58.32]). 评估的文章中有很大一部分 (33.1%) 被评为低质量,11.9%被评为非常低质量.
结论:
- AGREE II工具有助于提高CPG开发中的方法质量.
- 尽管总体上有所改善,但在特定领域,特别是适用性方面,持续存在的低质量问题需要指南开发人员的注意.
- 提高指南评估报告质量对于推动未来指南开发至关重要.
相关概念视频
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
121
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
121
Ethical Issues
861
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
861
Clinical Trials
6.6K
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
6.6K
Guidelines for Writing Outcome
2.7K
When developing expected outcomes for a patient care plan, the nurse should adhere to the following recommendations:
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
2.7K
Guidelines for Nursing Documentation I
1.0K
Quality documentation and reporting share essential characteristics that ensure they are practical and valuable resources for those who use them. These characteristics are:
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
1.0K
Clinical Trials: Overview
2.8K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
2.8K


