Abstract：
OBJECTIVE: Multiple groups have created clinical practice guidelines (CPGs) for the management of primary hyperparathyroidism (PHPT). This report provides a rigorous quality assessment using the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II) to identify high-performing guidelines and areas for improvement.
METHODS: A systematic review was conducted to isolate CPGs addressing the management of PHPT. Guideline data was extracted and quality ratings were assigned by four independent reviewers. Intraclass correlation coefficients (ICC) were calculated to ensure interrater reliability.
RESULTS: Twelve guidelines were assessed. The American Association of Endocrine Surgeons (AAES) guideline had the highest mean scaled score across all domains (73.6 ± 31.4%). No other published guideline achieved a \"high\" quality designation. The highest scoring domain was \"clarity of presentation\" (mean 60.5 ± 26.5%). The lowest scoring domain was \"applicability\" (mean 19.8 ± 18.2%). Scoring reliability was excellent, with ICC ≥ 0.89 for all AGREE II 6 domains.
CONCLUSIONS: Although several working groups have developed guidelines to address PHPT management, only those published by the AAES meet all methodologic quality criteria necessary to ensure incorporation of recommendations into clinical practice. Future guidelines would benefit from the development of tools, resources, monitoring criteria that enhance applicability.
METHODS: A systematic review was conducted to isolate CPGs addressing the management of PHPT. Guideline data was extracted and quality ratings were assigned by four independent reviewers. Intraclass correlation coefficients (ICC) were calculated to ensure interrater reliability.
RESULTS: Twelve guidelines were assessed. The American Association of Endocrine Surgeons (AAES) guideline had the highest mean scaled score across all domains (73.6 ± 31.4%). No other published guideline achieved a \"high\" quality designation. The highest scoring domain was \"clarity of presentation\" (mean 60.5 ± 26.5%). The lowest scoring domain was \"applicability\" (mean 19.8 ± 18.2%). Scoring reliability was excellent, with ICC ≥ 0.89 for all AGREE II 6 domains.
CONCLUSIONS: Although several working groups have developed guidelines to address PHPT management, only those published by the AAES meet all methodologic quality criteria necessary to ensure incorporation of recommendations into clinical practice. Future guidelines would benefit from the development of tools, resources, monitoring criteria that enhance applicability.
摘要：
目的：多个小组已经制定了原发性甲状旁腺功能亢进（PHPT）的临床实践指南（CPGs）。本报告使用《研究与评估工具评估指南》（AGREEII）进行了严格的质量评估，以确定高性能的指南和需要改进的领域。
方法：进行了系统评价，以分离针对PHPT管理的CPG。提取指南数据，并由四名独立审稿人分配质量评级。计算组内相关系数(ICC)以确保评分者间的可靠性。
结果：评估了12个指南。美国内分泌外科医师协会（AAES）指南在所有领域的平均评分最高（73.6±31.4％）。没有其他已发布的指南获得“高质量”称号。得分最高的领域是“呈现清晰度”(平均60.5±26.5%)。得分最低的领域是“适用性”(平均19.8±18.2%)。评分可靠性很好，所有AGREEII6域的ICC≥0.89。
结论：尽管几个工作组已经制定了解决PHPT管理的指南，只有AAES公布的方法符合确保将建议纳入临床实践所必需的所有方法学质量标准.未来的指导方针将受益于工具的发展，资源,增强适用性的监测标准。
方法：进行了系统评价，以分离针对PHPT管理的CPG。提取指南数据，并由四名独立审稿人分配质量评级。计算组内相关系数(ICC)以确保评分者间的可靠性。
结果：评估了12个指南。美国内分泌外科医师协会（AAES）指南在所有领域的平均评分最高（73.6±31.4％）。没有其他已发布的指南获得“高质量”称号。得分最高的领域是“呈现清晰度”(平均60.5±26.5%)。得分最低的领域是“适用性”(平均19.8±18.2%)。评分可靠性很好，所有AGREEII6域的ICC≥0.89。
结论：尽管几个工作组已经制定了解决PHPT管理的指南，只有AAES公布的方法符合确保将建议纳入临床实践所必需的所有方法学质量标准.未来的指导方针将受益于工具的发展，资源,增强适用性的监测标准。
