Abstract：
Abdominal aortic aneurysm (AAA) clinical practice guidelines (CPGs) provide evidence-based information on patient management; however, methodological differences exist in the development of CPGs. This study examines the methodological quality of AAA CPGs using a validated assessment tool.
Medline, EMBASE and online CPG databases were searched from 1946 to 31 October 2021. Full-text, English language, evidence-based AAA CPGs were included. Consensus-based CPGs, summaries of CPGs or CPGs which were only available on purchase were excluded. Five reviewers assessed their quality using the Appraisal of Guidelines for Research and Evaluation II instrument. An overall guideline assessment scaled score of ≥80% was considered as the threshold to recommend CPG use in clinical practice.
Seven CPGs were identified. Scores showed good inter-reviewer reliability (intraclass correlation coefficient 0.943, 95% CI 0.915 to 0.964). On average, CPGs performed adequately with mean scaled scores of over 50% in all domains. However, between CPGs, significant methodological heterogeneity was observed in all domains. Four CPGs scored ≥80% (European Society of Cardiology, the Society of Vascular Surgery, the European Society of Vascular Surgery and the National Institute of Health and Care Excellence), supporting their use in clinical practice.
Four CPGs were considered of adequate methodological quality to recommend their use in clinical practice; nonetheless, these still showed areas for improvement, potentially through performing economic analysis and trial application of recommendations. A structured approach employing validated CPG creation tools should be used to improve rigour of AAA CPGs. Future work should also evaluate recommendation accuracy using validated appraisal tools.
Medline, EMBASE and online CPG databases were searched from 1946 to 31 October 2021. Full-text, English language, evidence-based AAA CPGs were included. Consensus-based CPGs, summaries of CPGs or CPGs which were only available on purchase were excluded. Five reviewers assessed their quality using the Appraisal of Guidelines for Research and Evaluation II instrument. An overall guideline assessment scaled score of ≥80% was considered as the threshold to recommend CPG use in clinical practice.
Seven CPGs were identified. Scores showed good inter-reviewer reliability (intraclass correlation coefficient 0.943, 95% CI 0.915 to 0.964). On average, CPGs performed adequately with mean scaled scores of over 50% in all domains. However, between CPGs, significant methodological heterogeneity was observed in all domains. Four CPGs scored ≥80% (European Society of Cardiology, the Society of Vascular Surgery, the European Society of Vascular Surgery and the National Institute of Health and Care Excellence), supporting their use in clinical practice.
Four CPGs were considered of adequate methodological quality to recommend their use in clinical practice; nonetheless, these still showed areas for improvement, potentially through performing economic analysis and trial application of recommendations. A structured approach employing validated CPG creation tools should be used to improve rigour of AAA CPGs. Future work should also evaluate recommendation accuracy using validated appraisal tools.
摘要：
腹主动脉瘤(AAA)临床实践指南(CPGs)提供了有关患者管理的循证信息;然而,CPG的发展存在方法论差异。本研究使用经过验证的评估工具检查了AAACPG的方法学质量。
Medline,从1946年至2021年10月31日搜索了EMBASE和在线CPG数据库。全文,英语语言,纳入循证AAACPGs。基于共识的CPG，仅在购买时可用的CPG摘要或CPG被排除。五名审稿人使用《评估和评估指南II》工具评估了他们的质量。总体指南评估评分≥80％被认为是建议在临床实践中使用CPG的阈值。
确定了7个CPG。评分显示出良好的审阅者间可靠性（组内相关系数0.943，95％CI0.915至0.964）。平均而言,在所有领域中，CPG表现充分，平均评分超过50％。然而,在CPG之间，在所有领域均观察到显著的方法学异质性.四个CPG得分≥80%(欧洲心脏病学会，血管外科学会,欧洲血管外科学会和国家健康与护理卓越研究所)，支持它们在临床实践中的使用。
四种CPG被认为具有足够的方法学质量，以推荐其在临床实践中的使用；尽管如此，这些仍然显示了需要改进的地方，可能通过进行经济分析和试用建议。应使用采用经过验证的CPG创建工具的结构化方法来提高AAACPG的严谨性。未来的工作还应该使用经过验证的评估工具来评估推荐的准确性。
Medline,从1946年至2021年10月31日搜索了EMBASE和在线CPG数据库。全文,英语语言,纳入循证AAACPGs。基于共识的CPG，仅在购买时可用的CPG摘要或CPG被排除。五名审稿人使用《评估和评估指南II》工具评估了他们的质量。总体指南评估评分≥80％被认为是建议在临床实践中使用CPG的阈值。
确定了7个CPG。评分显示出良好的审阅者间可靠性（组内相关系数0.943，95％CI0.915至0.964）。平均而言,在所有领域中，CPG表现充分，平均评分超过50％。然而,在CPG之间，在所有领域均观察到显著的方法学异质性.四个CPG得分≥80%(欧洲心脏病学会，血管外科学会,欧洲血管外科学会和国家健康与护理卓越研究所)，支持它们在临床实践中的使用。
四种CPG被认为具有足够的方法学质量，以推荐其在临床实践中的使用；尽管如此，这些仍然显示了需要改进的地方，可能通过进行经济分析和试用建议。应使用采用经过验证的CPG创建工具的结构化方法来提高AAACPG的严谨性。未来的工作还应该使用经过验证的评估工具来评估推荐的准确性。
