困难的气道管理:对系统审查证据的分析,以支持临床实践指南
Bryan Dunford1, Bethany Sutterfield2, Will Roberts1
1Department of Anesthesiology, Oklahoma State University Medical Center, Tulsa, OK, United States.
Anaesthesia, critical care & pain medicine
|May 3, 2025
概括
对于难以管理气道 (DAM) 临床实践指南 (CPG) 的系统性审查 (SRs) 显示出不同的质量. 改进SR方法和报告,特别是使用Cochrane评论,对于可靠的患者护理建议至关重要.
科学领域:
- 麻醉学 麻醉学
- 基于证据的医学 基于证据的医学
- 健康科学 卫生科学 卫生科学
背景情况:
- 系统性审查 (SRs) 是困难的气道管理 (DAM) 临床实践指南 (CPG) 的基础.
- 特别报告的方法和报告质量显著影响临床决策和DAM患者的结果.
- 确保准确,基于证据的医学对于医疗保健专业人员管理困难的呼吸道至关重要.
研究的目的:
- 评估DAM CPG中使用的SR的方法和报告质量.
- 确定需要改善SR质量的领域,以提高DAM CPG的可靠性.
- 在DAM指南的背景下,比较Cochrane和非CochraneSR的质量.
主要方法:
- 一项系统的搜索确定了2015-2021年期间发表的DAM CPG.
- 这些CPG中引用的SRs使用PRISMA和AMSTAR-2检查清单进行了评估.
- 考克兰和非考克兰SRs之间的质量评分进行了比较.
主要成果:
- 在来自14个CPG的63个SR中,有20个知情建议.
- 普利斯马和AMSTAR-2的平均分数分别为73.4%和49.3%,表明质量中度至极低.
- 仅包括三个Cochrane SRs,但它们在AMSTAR-2上得分高于非Cochrane SRs.
结论:
- 在DAM CPG中,SR的质量不一致,需要遵守更高的报告和方法标准.
- 由于仅限于高质量的Cochrane SRs,这可能会削弱指南的可靠性.
- 改进DAM CPG需要在准则开发过程中整合优质的SR和严格的评估.
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