Abstract：
To examine and critique current international clinical practice guidelines (CPGs) on management of paediatric neurogenic lower urinary tract dysfunction (NLUTD) and assess the applicability of these guidelines to clinical practice.
We conducted a systematic review of all CPGs on NLUTD published in English from the year 2010 to 2022. Six reviewers independently used the Appraisal of Guidelines and Research Evaluation (AGREE) II instrument to appraise all eligible CPGs. This instrument is comprised of 23 items organised into six quality domains. The scores for each item and domain were tabulated for each reviewer and interrater reliability was assessed for each domain using the intraclass correlation coefficient (ICC).
Six CPGs were appraised and these included: National Institute for Health and Care Excellence (NICE), European Society for Paediatric Urology, International Children\'s Continence Society, Irish, Spina Bifida Association (SBA), and International Brazilian Journal of Urology guidelines. They had high mean standardised scores in the domain on \'scope and purpose\' and \'clarity of presentation\' but had low scores in the domain of \'applicability\'. The top three CPGs based on overall score were the NICE, Irish and SBA guidelines and the reviewers had high degree of interrater reliability (ICC 0.912, P < 0.001). The mean scores in various domains for the top three guidelines were 95.8 (scope and purpose), 87.5 (stakeholder involvement), 69.1 (rigour of development), 94.0 (clarity of presentation), 68.4 (applicability), and 59.7 (editorial independence). The diagnostic and treatment recommendations of the top three guidelines were presented.
The existing CPGs on paediatric NLUTD provide high-quality evidence based recommendations. The NICE, Irish and SBA guidelines were the top three CPGs identified. They scored high on most domains except applicability and editorial independence. These domains need to be considered for future updates to improve the utility.
We conducted a systematic review of all CPGs on NLUTD published in English from the year 2010 to 2022. Six reviewers independently used the Appraisal of Guidelines and Research Evaluation (AGREE) II instrument to appraise all eligible CPGs. This instrument is comprised of 23 items organised into six quality domains. The scores for each item and domain were tabulated for each reviewer and interrater reliability was assessed for each domain using the intraclass correlation coefficient (ICC).
Six CPGs were appraised and these included: National Institute for Health and Care Excellence (NICE), European Society for Paediatric Urology, International Children\'s Continence Society, Irish, Spina Bifida Association (SBA), and International Brazilian Journal of Urology guidelines. They had high mean standardised scores in the domain on \'scope and purpose\' and \'clarity of presentation\' but had low scores in the domain of \'applicability\'. The top three CPGs based on overall score were the NICE, Irish and SBA guidelines and the reviewers had high degree of interrater reliability (ICC 0.912, P < 0.001). The mean scores in various domains for the top three guidelines were 95.8 (scope and purpose), 87.5 (stakeholder involvement), 69.1 (rigour of development), 94.0 (clarity of presentation), 68.4 (applicability), and 59.7 (editorial independence). The diagnostic and treatment recommendations of the top three guidelines were presented.
The existing CPGs on paediatric NLUTD provide high-quality evidence based recommendations. The NICE, Irish and SBA guidelines were the top three CPGs identified. They scored high on most domains except applicability and editorial independence. These domains need to be considered for future updates to improve the utility.
摘要：
目的：审查和批评当前国际上关于儿科神经源性下尿路功能障碍（NUUTD）管理的临床实践指南（CPGs），并评估这些指南在临床实践中的适用性。
方法：我们对2010年至2022年以英文发布的所有NUTDCPG进行了系统回顾。六名评审员独立使用评估指南和研究评估（AGREE）II工具来评估所有合格的CPG。该仪器由23个项目组成，分为六个质量领域。为每个审阅者列出每个项目和领域的得分，并使用组内相关系数（ICC）评估每个领域的评分者间可靠性。
结果：评估了六个CPG，其中包括：国家健康与护理卓越研究所（NICE），欧洲儿科泌尿外科学会，国际儿童继续协会，爱尔兰人,脊柱裂协会（SBA），和国际巴西泌尿外科杂志指南。他们在“范围和目的”和“演示的清晰度”领域的平均标准化得分很高，但在“适用性”领域的得分很低。根据总分排名前三的CPG是NICE，IrishandSBAguidelinesandthereviewershadhighdegreeofinterraterreliability(ICC0.912,P<0.001).前三名指南在各个领域的平均得分为95.8（范围和目的），87.5（利益相关者参与），69.1(严格的开发)，94.0（表述清晰），68.4（适用性），和59.7（编辑独立性）。介绍了前三名指南的诊断和治疗建议。
结论：现有的关于儿科NIUTD的CPG提供了高质量的循证建议。NICE,爱尔兰和SBA指南是确定的前三名CPG。除了适用性和编辑独立性外，他们在大多数领域都得分很高。这些域需要考虑将来的更新，以提高实用性。
方法：我们对2010年至2022年以英文发布的所有NUTDCPG进行了系统回顾。
结果：评估了六个CPG，其中包括：国家健康与护理卓越研究所（NICE），
结论：现有的关于儿科NIUTD的CPG提供了高质量的循证建议。
