Abstract:
Bell\'s palsy, or idiopathic facial paralysis, is a peripheral facial palsy of unknown cause that presents as sudden, unilateral weakness of the muscles of the face. Prompt treatment of Bell\'s palsy is critical in order for patients to achieve complete recovery of facial function. Delays in diagnosis and management can result in permanent facial defects. A number of clinical practice guidelines (CPG) exist to guide clinical decision-making in patients presenting with idiopathic facial paralysis. However, to date, there has been no comprehensive review of the methodological rigor and quality of these CPGs. Thus, the objective of the authors is to appraise the existing CPGs to ensure safe and effective practices. A total of eight guidelines met the inclusion criteria and were appraised. Only two CPGs achieved an overall rating of \'High\', having five or more quality domains scoring > 60%. Across the CPGs, the domains of rigor of development, stakeholder involvement, and applicability has the lowest overall scores with 48.1%, 43.9%, and 43.1%, respectively. Based on the AGREE II instrument, the methodological rigor and quality of CPGs for Bell\'s palsy is low to average. In particular, future guidelines for Bell\'s palsy should look to the quality domains of rigor of development, stakeholder involvement, and applicability as the greatest opportunities for improvement.
摘要:
贝尔麻痹,或者特发性面神经麻痹,是一种原因不明的周围性面神经麻痹,表现为突然的,面部肌肉的单侧无力。及时治疗贝尔氏麻痹是患者面部功能完全恢复的关键。诊断和管理的延迟会导致永久性面部缺陷。存在许多临床实践指南(CPG)来指导特发性面神经麻痹患者的临床决策。然而,到目前为止,尚未对这些CPG的方法严密性和质量进行全面审查。因此,作者的目的是评估现有的CPG,以确保安全和有效的做法。共有8项准则符合纳入标准,并进行了评估。只有两个CPG获得了“高”的总体评级,有五个或更多的质量领域得分>60%。在CPG上,发展的严谨性领域,利益相关者的参与,适用性总分最低,为48.1%,43.9%,和43.1%,分别。根据AGREEII文书,贝尔氏麻痹的CPG的方法学严谨和质量低到平均水平。特别是,贝尔麻痹的未来指南应该着眼于发展的严格性的质量领域,利益相关者的参与,和适用性是最大的改进机会。