Abstract：
BACKGROUND: To appraise the quality of clinical practice guidelines for glaucoma suspects, and to assess their consistency for how a \'glaucoma suspect\' is defined and their recommendations for treatment initiation for such individuals.
METHODS: This study included all documents that self-identified as a \'guideline\' and provided recommendation(s) for the clinical care of glaucoma suspects. The quality of eligible guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.
RESULTS: From 1196 records retrieved from comprehensive searches and two records manually included, 20 clinical practice guidelines were deemed eligible. Based on an appraisal using the AGREE II instrument, 16 (80%) guidelines had ≤2 domains with scores >66%. Overall, the lowest scoring domains were for applicability, editorial independence and stakeholder involvement. There was relatively poor agreement across the guidelines for what defines a \'glaucoma suspect\' or \'primary open angle glaucoma [POAG] suspect\', as well as the recommendations and criteria for treatment initiation in these populations. There was better agreement for the definition and recommendations for treatment initiation for \'primary angle closure suspects\'.
CONCLUSIONS: There is substantial room to improve the methodological quality of most current international clinical guidelines for glaucoma suspects. Clinicians should consider this finding when using such guidelines to inform their care of glaucoma suspects. Substantial variation in the definition of a POAG suspect and recommendations for treatment initiation underscores important gaps in the current evidence for the accurate prediction of glaucoma development and treatment effectiveness in these individuals.
METHODS: This study included all documents that self-identified as a \'guideline\' and provided recommendation(s) for the clinical care of glaucoma suspects. The quality of eligible guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.
RESULTS: From 1196 records retrieved from comprehensive searches and two records manually included, 20 clinical practice guidelines were deemed eligible. Based on an appraisal using the AGREE II instrument, 16 (80%) guidelines had ≤2 domains with scores >66%. Overall, the lowest scoring domains were for applicability, editorial independence and stakeholder involvement. There was relatively poor agreement across the guidelines for what defines a \'glaucoma suspect\' or \'primary open angle glaucoma [POAG] suspect\', as well as the recommendations and criteria for treatment initiation in these populations. There was better agreement for the definition and recommendations for treatment initiation for \'primary angle closure suspects\'.
CONCLUSIONS: There is substantial room to improve the methodological quality of most current international clinical guidelines for glaucoma suspects. Clinicians should consider this finding when using such guidelines to inform their care of glaucoma suspects. Substantial variation in the definition of a POAG suspect and recommendations for treatment initiation underscores important gaps in the current evidence for the accurate prediction of glaucoma development and treatment effectiveness in these individuals.
摘要：
背景：为了评估青光眼嫌疑人临床实践指南的质量，并评估他们如何定义“青光眼嫌疑人”的一致性，以及他们对此类个体开始治疗的建议。
方法：本研究包括所有自我认定为“指南”的文件，并为青光眼嫌疑人的临床护理提供建议。使用评估研究和评估指南（AGREE）II工具评估合格指南的质量。
结果：从综合搜索中检索到的1196条记录和手动包含的两条记录中，20个临床实践指南被认为是合格的。根据使用AGREEII工具的评估，16（80％）指南有≤2个领域，得分>66％。总的来说,得分最低的领域是适用性，编辑独立性和利益相关者参与。关于“青光眼可疑者”或“原发性开角型青光眼[POAG]可疑者”的定义，指南之间的一致性相对较差，以及在这些人群中开始治疗的建议和标准。对于“原发性闭角嫌疑犯”的治疗开始的定义和建议达成了更好的共识。
结论：目前大多数国际青光眼疑似病例临床指南的方法学质量仍有很大的提高空间。临床医生在使用此类指南告知他们对青光眼嫌疑人的护理时，应考虑这一发现。POAG疑似病例的定义和开始治疗的建议存在很大差异，这突显了当前准确预测这些个体青光眼发展和治疗有效性的证据中的重要差距。
方法：本研究包括所有自我认定为“指南”的文件，并为青光眼嫌疑人的临床护理提供建议。使用评估研究和评估指南（AGREE）II工具评估合格指南的质量。
结果：从综合搜索中检索到的1196条记录和手动包含的两条记录中，20个临床实践指南被认为是合格的。根据使用AGREEII工具的评估，16（80％）指南有≤2个领域，得分>66％。总的来说,得分最低的领域是适用性，编辑独立性和利益相关者参与。关于“青光眼可疑者”或“原发性开角型青光眼[POAG]可疑者”的定义，指南之间的一致性相对较差，以及在这些人群中开始治疗的建议和标准。对于“原发性闭角嫌疑犯”的治疗开始的定义和建议达成了更好的共识。
结论：目前大多数国际青光眼疑似病例临床指南的方法学质量仍有很大的提高空间。临床医生在使用此类指南告知他们对青光眼嫌疑人的护理时，应考虑这一发现。POAG疑似病例的定义和开始治疗的建议存在很大差异，这突显了当前准确预测这些个体青光眼发展和治疗有效性的证据中的重要差距。
