PDF(Pubmed)
Abstract：
BACKGROUND: Acute ankle injuries are commonly seen in emergency rooms, with significant social impact and potentially devastating consequences. While several clinical practice guidelines (CPGs) related to ankle injuries have been developed by various organizations, there is a lack of critical appraisal of them. The purpose of this systematic review is to identify and critically appraise evidence-based clinical practice guidelines (EB-CPGs) related to acute ankle injuries in adults.
METHODS: We conducted searches in the Cochrane Library, MEDLINE, EMBASE databases, WHO, and reviewed 98 worldwide orthopedic association websites up until early 2023. Two authors independently applied the inclusion and exclusion criteria, and each evidence-based clinical practice guideline (EB-CPG) underwent independent critical appraisal of its content by all four authors using the Appraisal of Guidelines for REsearch and Evaluation (AGREE II) instrument. AGREE II scores for each domain were then calculated.
RESULTS: This review included five evidence-based clinical practice guidelines. The mean scores for all six domains were as follows: Scope and Purpose (87.8%), Stakeholder Involvement (69.2%), Rigour of Development (72.5%), Clarity of Presentation (86.9%), Applicability (45.6%), and Editorial Independence (53.3%).
CONCLUSIONS: The number of EB-CPGs related to ankle injuries are limited and the overall quality of the existing evidence-based clinical practice guidelines (EB-CPGs) for ankle injuries is not strong, with three of them being outdated. However, valuable guidance related to Ottawa rules, manual therapy, cryotherapy, functional supports, early ambulation, and rehabilitation has been highlighted. Challenges remain in areas such as monitoring and/or auditing criteria, consideration of the target population\'s views and preferences, and ensuring editorial independence. Future guidelines should prioritize improvements in these domains to enhance the quality and relevance of ankle injury management.
UNASSIGNED: Systematic review.
METHODS: We conducted searches in the Cochrane Library, MEDLINE, EMBASE databases, WHO, and reviewed 98 worldwide orthopedic association websites up until early 2023. Two authors independently applied the inclusion and exclusion criteria, and each evidence-based clinical practice guideline (EB-CPG) underwent independent critical appraisal of its content by all four authors using the Appraisal of Guidelines for REsearch and Evaluation (AGREE II) instrument. AGREE II scores for each domain were then calculated.
RESULTS: This review included five evidence-based clinical practice guidelines. The mean scores for all six domains were as follows: Scope and Purpose (87.8%), Stakeholder Involvement (69.2%), Rigour of Development (72.5%), Clarity of Presentation (86.9%), Applicability (45.6%), and Editorial Independence (53.3%).
CONCLUSIONS: The number of EB-CPGs related to ankle injuries are limited and the overall quality of the existing evidence-based clinical practice guidelines (EB-CPGs) for ankle injuries is not strong, with three of them being outdated. However, valuable guidance related to Ottawa rules, manual therapy, cryotherapy, functional supports, early ambulation, and rehabilitation has been highlighted. Challenges remain in areas such as monitoring and/or auditing criteria, consideration of the target population\'s views and preferences, and ensuring editorial independence. Future guidelines should prioritize improvements in these domains to enhance the quality and relevance of ankle injury management.
UNASSIGNED: Systematic review.
摘要：
背景：急性踝关节损伤常见于急诊室，具有重大的社会影响和潜在的破坏性后果。虽然不同组织已经制定了一些与踝关节损伤相关的临床实践指南(CPGs)，对他们缺乏批判性的评价。本系统评价的目的是确定和严格评估与成人急性踝关节损伤相关的循证临床实践指南（EB-CPG）。
方法：我们在Cochrane图书馆进行了搜索，MEDLINE,EMBASE数据库,WHO,并审查了截至2023年初的98个全球骨科协会网站。两位作者独立应用了纳入和排除标准，每个循证临床实践指南（EB-CPG）都由所有四位作者使用重新搜索和评估指南（AGREEII）工具对其内容进行了独立的批判性评估。然后计算每个域的AGREEII分数。
结果：本综述包括五项循证临床实践指南。所有六个领域的平均得分如下：范围和目的(87.8%)，利益相关者参与（69.2%），严谨的发展（72.5%），呈现的清晰度（86.9%），适用性（45.6%），编辑独立性（53.3%）。
结论：与踝关节损伤相关的EB-CPG数量有限，现有踝关节损伤循证临床实践指南（EB-CPG）的总体质量不强，其中三个已经过时了。然而,有关渥太华规则的宝贵指导，手动治疗,冷冻疗法,功能支持，早期行走，康复得到了强调。监测和/或审计标准等领域仍然存在挑战，考虑目标人群的观点和偏好，并确保编辑独立性。未来的指南应优先考虑这些领域的改进，以提高踝关节损伤管理的质量和相关性。
■系统评价。
方法：我们在Cochrane图书馆进行了搜索，MEDLINE,EMBASE数据库,WHO,并审查了截至2023年初的98个全球骨科协会网站。两位作者独立应用了纳入和排除标准，每个循证临床实践指南（EB-CPG）都由所有四位作者使用重新搜索和评估指南（AGREEII）工具对其内容进行了独立的批判性评估。然后计算每个域的AGREEII分数。
结果：本综述包括五项循证临床实践指南。所有六个领域的平均得分如下：范围和目的(87.8%)，利益相关者参与（69.2%），严谨的发展（72.5%），呈现的清晰度（86.9%），适用性（45.6%），编辑独立性（53.3%）。
结论：与踝关节损伤相关的EB-CPG数量有限，现有踝关节损伤循证临床实践指南（EB-CPG）的总体质量不强，其中三个已经过时了。然而,有关渥太华规则的宝贵指导，手动治疗,冷冻疗法,功能支持，早期行走，康复得到了强调。监测和/或审计标准等领域仍然存在挑战，考虑目标人群的观点和偏好，并确保编辑独立性。未来的指南应优先考虑这些领域的改进，以提高踝关节损伤管理的质量和相关性。
■系统评价。
