Abstract：
We performed a quality assessment and comparison of clinical practice guidelines (CPGs) for the prevention and treatment of venous thromboembolism (VTE) in pediatric patients and to provide a clinical reference.
Electronic databases, guideline development organizations, and professional societies were searched to identify CPGs for VTE in pediatric patients between January 1, 2012, and April 7, 2022. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate quality. Recommendations for preventing and treating VTE in pediatric patients were extracted via descriptive synthesis.
Six CPGs were included. The median scores (interquartile range [IQR]) for each AGREE II domain were as follows: scope and purpose, 88.89 % (IQR: 8.33 %); stakeholder involvement, 88.89 % (25 %); rigor of development, 67.71 % (24.47 %); clarity and presentation, 88.89 % (0 %); applicability, 50 % (42.71 %); and editorial independence, 66.67 % (50.00 %). In total, 268 key recommendations were extracted, and traditional anticoagulants (heparin and warfarin) remain the standard treatment. However, in recent years direct oral anticoagulants (DOACs) have shown similar efficacy and safety results for the treatment of VTE in children to those reported in adults; therefore, this practice is recommended in recent guidelines.
Variability exists in the development and reporting of CPGs for VTE in pediatric patients. There may be changes to the recommendations for the prevention and treatment of VTE in pediatrics in the future due to the efficacy of DOACs in children, and recommendations should be revised periodically as new evidence emerges.
Electronic databases, guideline development organizations, and professional societies were searched to identify CPGs for VTE in pediatric patients between January 1, 2012, and April 7, 2022. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate quality. Recommendations for preventing and treating VTE in pediatric patients were extracted via descriptive synthesis.
Six CPGs were included. The median scores (interquartile range [IQR]) for each AGREE II domain were as follows: scope and purpose, 88.89 % (IQR: 8.33 %); stakeholder involvement, 88.89 % (25 %); rigor of development, 67.71 % (24.47 %); clarity and presentation, 88.89 % (0 %); applicability, 50 % (42.71 %); and editorial independence, 66.67 % (50.00 %). In total, 268 key recommendations were extracted, and traditional anticoagulants (heparin and warfarin) remain the standard treatment. However, in recent years direct oral anticoagulants (DOACs) have shown similar efficacy and safety results for the treatment of VTE in children to those reported in adults; therefore, this practice is recommended in recent guidelines.
Variability exists in the development and reporting of CPGs for VTE in pediatric patients. There may be changes to the recommendations for the prevention and treatment of VTE in pediatrics in the future due to the efficacy of DOACs in children, and recommendations should be revised periodically as new evidence emerges.
摘要：
背景：我们对儿科患者静脉血栓栓塞症（VTE）的预防和治疗进行了质量评估和临床实践指南（CPGs）的比较，并提供临床参考。
方法：电子数据库，指导方针发展组织，在2012年1月1日至2022年4月7日期间,我们搜索了专业协会,以确定儿科患者VTE的CPGs.使用指南研究与评估（AGREE）II工具进行质量评估。通过描述性综合提取儿科患者预防和治疗VTE的建议。
结果：包含6个CPG。每个AGREEII域的中位数分数（四分位数范围[IQR]）如下：范围和目的，88.89%（IQR：8.33%）；利益相关者参与，88.89%(25%)；发展的严谨性，67.71%(24.47%)；清晰度和呈现，88.89%（0%）；适用性，50%(42.71%)；和编辑独立性，66.67%(50.00%)。总的来说,提取了268条关键建议，和传统的抗凝剂（肝素和华法林）仍然是标准的治疗方法。然而,近年来，直接口服抗凝药（DOACs）在治疗儿童VTE方面显示出与成人相似的疗效和安全性结果；因此，最近的指南建议采用这种做法。
结论：儿科患者VTECPG的开发和报告存在变异性。由于DOAC对儿童的疗效，未来儿科预防和治疗VTE的建议可能会发生变化，随着新证据的出现，建议应定期修订。
方法：电子数据库，指导方针发展组织，在2012年1月1日至2022年4月7日期间,我们搜索了专业协会,以确定儿科患者VTE的CPGs.使用指南研究与评估（AGREE）II工具进行质量评估。通过描述性综合提取儿科患者预防和治疗VTE的建议。
结果：包含6个CPG。每个AGREEII域的中位数分数（四分位数范围[IQR]）如下：范围和目的，88.89%（IQR：8.33%）；利益相关者参与，88.89%(25%)；发展的严谨性，67.71%(24.47%)；清晰度和呈现，88.89%（0%）；适用性，50%(42.71%)；和编辑独立性，66.67%(50.00%)。总的来说,提取了268条关键建议，和传统的抗凝剂（肝素和华法林）仍然是标准的治疗方法。然而,近年来，直接口服抗凝药（DOACs）在治疗儿童VTE方面显示出与成人相似的疗效和安全性结果；因此，最近的指南建议采用这种做法。
结论：儿科患者VTECPG的开发和报告存在变异性。由于DOAC对儿童的疗效，未来儿科预防和治疗VTE的建议可能会发生变化，随着新证据的出现，建议应定期修订。
