儿童中耳炎循证指南AGREEⅡ质量评价情况

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摘要目的评价儿童中耳炎临床实践指南质量，为临床医师及药师鉴别高质量的指南。方法计算机检索中国知网、万方数据库、维普、中国生物医学文献数据库、PubMed、Embase及医脉通官网、国际指南联盟、美国儿科协会、国家指南数据库、英国国家卫生和临床示范研究所等网站，检索时限为2000年1月至2019年6月。中文检索词为中耳炎、临床实践指南、儿童，英文检索词包括otitis media、middle ear、glue ear、guideline、guidance、child、children。纳入儿童中耳炎临床实践指南，应用临床指南研究与评价系统（AGREEⅡ）对指南质量进行评价。结果纳入指南10篇，包括5篇循证指南、5篇非循证指南。3名研究者评定各指南结果一致性较高，10篇指南评定结果分别为英国（ICC = 0.876，F = 22.271，P ＜ 0.001）、美国1（ICC = 0.861，F = 19.509，P ＜ 0.001）、美国2（ICC = 0.819，F = 14.587，P ＜ 0.001）、日本（ICC = 0.853，F = 18.531，P ＜ 0.001）、韩国（ICC = 0.856，F = 18.894，P ＜ 0.001）、新南威尔士（ICC = 0.865，F = 20.277，P ＜ 0.001）、中国（ICC = 0.836，F = 16.258，P ＜ 0.001）、加拿大1（ICC = 0.894，F = 26.342，P ＜ 0.001）、加拿大2（ICC = 0.880，F = 22.997，P ＜ 0.001）、国际（ICC = 0.795，F = 12.605，P ＜ 0.001），差异有统计学意义。10篇指南总体质量不高，其中1篇为A级，4篇为B级，5篇为C级，各领域中“清晰性”与“范围与目的”得分较高，分别为70.2%与67.8%，而“编辑独立性”与“应用性”得分相对较低，分别为34.0%与29.7%。结论纳入指南质量相对较低，我国现有的儿童中耳炎临床实践指南质量不高，建议采用循证制定的方法，制订符合我国国情的循证指南。

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	丁翔宇1 张古英1 王伟秀2 李瑞宏1

关键词 ：中耳炎, 临床指南, 儿童, 临床指南研究与评价系统

Abstract：Objective To evaluate the quality of clinical practice guidelines for otitis media in children, and to identify high quality guidelines for clinicians and pharmacists. Methods China National Knowledge Infrastucture, Wanfang Chinese Periodical Database, VIP Chinese Periodical Database, CBM database, PubMed database, Excerpta Medica Database and relevant websites, such as medlive.cn, GIN, AAP, NGC, NICE were searched by computer ranged from January 2000 to June 2019. Chinese search terms were otitis media, guidelines for clinical practice and children while English search terms were otitis media, middle ear, glue ear, guideline, guidance, child and children. Clinical practice guidelines for otitis media in children were included, appraisal of guidelines research and evaluation in Europe (AGREEⅡ) instrument was used to evaluate the quality of clinical practice guidelines. Results Ten guidelines were included, 5 of them were evidence-based (EB) guidelines, and 5 were non-EB guidelines. The consistency of 10 guidelines rated by three researchers was high. The evaluation results were as followed: the UK (ICC = 0.876, F = 22.271, P ＜ 0.001), the USA 1(ICC = 0.861, F = 19.509, P ＜ 0.001)，the USA 2 (ICC = 0.819, F = 14.587, P ＜ 0.001)，Japan (ICC = 0.853, F = 18.531, P ＜ 0.001)，Korea (ICC = 0.856, F = 18.894, P ＜ 0.001)，New South Wales (ICC = 0.865, F = 20.277, P ＜ 0.001)，China (ICC = 0.836, F = 16.258, P ＜ 0.001), Canada 1 (ICC = 0.894, F = 26.342, P ＜ 0.001)，Canada 2 (ICC = 0.880, F = 22.997, P ＜ 0.001), the international guideline (ICC = 0.795, F = 12.605, P ＜ 0.001), the differences were statistically significant. The overall quality of the 10 guidelines was not high. One was at grade A, four were at grade B, and five were at grade C. In each field, “clarity” and “scope and purpose” scored high (70.2% and 67.8% respectively), while “editorial independence” and “application” scored relatively low (34.0% and 29.7% respectively). Conclusion The quality of the included guidelines is relatively low. The quality of clinical practice guidelines for otitis media in children in China is not high. It is recommended to adopt EB methods to develop EB guidelines that are consistent with China′s national conditions.

Key words： Otitis media Guideline Children Appraisal of guidelines research and evaluation in Europe

基金资助:河北省卫生厅医学科学研究课题计划（20150567）。

作者简介: 丁翔宇（1981-），女，硕士，副主任药师，主要从事临床药学工作。

引用本文:

丁翔宇1 张古英1 王伟秀2 李瑞宏1. 儿童中耳炎循证指南AGREEⅡ质量评价情况[J]. 中国医药导报, 2019, 16(30): 114-117.
DING Xiangyu1 ZHANG Guying1 WANG Weixiu2 LI Ruihong1. Quality evaluation of guidelines on otitis media in children based on AGREEⅡ. 中国医药导报, 2019, 16(30): 114-117.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I30/114

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