Abstract：
BACKGROUND: To systematically evaluate the quality of the guidelines for the diagnosis and treatment of Helicobacter pylori infection and to analyze the differences and reasons for the key recommendations in the guidelines.
METHODS: Databases and websites were systematically searched to obtain guidelines for the diagnosis and treatment of Helicobacter pylori infection. Four independent reviewers used the Guideline Evaluation Tool (AGREE II) to evaluate the included guidelines. The intraclass correlation coefficient (ICC) and Fleiss\' kappa coefficient were used to measure the consistency of evaluation guidelines between guide reviewers. Differences between guidelines and the reasons for the differences were analyzed by comparing the recommendations of different guidelines and the evidence supporting the recommendations.
RESULTS: A total of 17 guidelines for Helicobacter pylori infection were included in this study. The AGREE II scores of these guidelines were low overall, with 4 of them had a score of over 60%, which indicates that the guidelines are recommended, and 13 of them having a score ranging from 30 to 60%, which indicates that the guidelines are recommended but need to be revised, while no guideline had a score of 30% or less, which indicates that they were not recommended. The analysis of these guidelines found that there were some differences in the main recommendations. Not all guidelines recommend sequential therapy as the recommended therapy. Whether bismuth quadruple therapy should be used as the recommended first-line therapy is unclear. The antibiotic resistance rate is different in different regions. Combined with the local antibiotic sensitivity test, the eradication rate of Helicobacter pylori can be improved.
CONCLUSIONS: There are significant differences in the quality of Helicobacter pylori infection guidelines and the key recommendations. Improving the deficiencies of existing guidelines is an effective way to develop high-quality guidelines and make reasonable recommendations for the treatment of Helicobacter pylori infection in the future.
METHODS: Databases and websites were systematically searched to obtain guidelines for the diagnosis and treatment of Helicobacter pylori infection. Four independent reviewers used the Guideline Evaluation Tool (AGREE II) to evaluate the included guidelines. The intraclass correlation coefficient (ICC) and Fleiss\' kappa coefficient were used to measure the consistency of evaluation guidelines between guide reviewers. Differences between guidelines and the reasons for the differences were analyzed by comparing the recommendations of different guidelines and the evidence supporting the recommendations.
RESULTS: A total of 17 guidelines for Helicobacter pylori infection were included in this study. The AGREE II scores of these guidelines were low overall, with 4 of them had a score of over 60%, which indicates that the guidelines are recommended, and 13 of them having a score ranging from 30 to 60%, which indicates that the guidelines are recommended but need to be revised, while no guideline had a score of 30% or less, which indicates that they were not recommended. The analysis of these guidelines found that there were some differences in the main recommendations. Not all guidelines recommend sequential therapy as the recommended therapy. Whether bismuth quadruple therapy should be used as the recommended first-line therapy is unclear. The antibiotic resistance rate is different in different regions. Combined with the local antibiotic sensitivity test, the eradication rate of Helicobacter pylori can be improved.
CONCLUSIONS: There are significant differences in the quality of Helicobacter pylori infection guidelines and the key recommendations. Improving the deficiencies of existing guidelines is an effective way to develop high-quality guidelines and make reasonable recommendations for the treatment of Helicobacter pylori infection in the future.
摘要：
背景：系统评估幽门螺杆菌感染诊断和治疗指南的质量，并分析指南中关键建议的差异和原因。
方法：系统检索数据库和网站，以获得幽门螺杆菌感染的诊断和治疗指南。四名独立审核员使用指南评估工具（AGREEII）来评估所包括的指南。使用组内相关系数（ICC）和Fleiss\'kappa系数来衡量指南审阅者之间评估指南的一致性。通过比较不同指南的建议和支持建议的证据，分析指南之间的差异以及差异的原因。
结果：本研究共纳入17条幽门螺杆菌感染指南。这些指南的AGREEII评分总体较低，其中4人得分超过60%，这表明指南是推荐的，其中13人的分数从30%到60%不等，这表明准则是推荐的，但需要修改，虽然没有指南的分数是30%或更低，这表明他们不被推荐。对这些指南的分析发现，主要建议存在一些差异。并非所有指南都推荐序贯疗法作为推荐疗法。铋剂四联疗法是否应作为推荐的一线疗法尚不清楚。不同地区的抗生素耐药率不同。结合局部抗生素敏感性试验，可以提高幽门螺杆菌的根除率。
结论：幽门螺杆菌感染指南和关键建议的质量存在显著差异。改进现有指南的不足是制定高质量指南并为今后幽门螺杆菌感染的治疗提出合理建议的有效途径。
方法：系统检索数据库和网站，以获得幽门螺杆菌感染的诊断和治疗指南。四名独立审核员使用指南评估工具（AGREEII）来评估所包括的指南。使用组内相关系数（ICC）和Fleiss\'kappa系数来衡量指南审阅者之间评估指南的一致性。通过比较不同指南的建议和支持建议的证据，分析指南之间的差异以及差异的原因。
结果：本研究共纳入17条幽门螺杆菌感染指南。这些指南的AGREEII评分总体较低，其中4人得分超过60%，这表明指南是推荐的，其中13人的分数从30%到60%不等，这表明准则是推荐的，但需要修改，虽然没有指南的分数是30%或更低，这表明他们不被推荐。对这些指南的分析发现，主要建议存在一些差异。并非所有指南都推荐序贯疗法作为推荐疗法。铋剂四联疗法是否应作为推荐的一线疗法尚不清楚。不同地区的抗生素耐药率不同。结合局部抗生素敏感性试验，可以提高幽门螺杆菌的根除率。
结论：幽门螺杆菌感染指南和关键建议的质量存在显著差异。改进现有指南的不足是制定高质量指南并为今后幽门螺杆菌感染的治疗提出合理建议的有效途径。
