使用研究和评估指南II(AGREEII)工具评估肯尼亚可用和可访问的国家临床实践指南(CPG)的质量。
我们搜索了肯尼亚卫生部的网站,专业协会和联系相关组织的专家。我们的范围是关于孕产妇的指导方针,新生儿,营养障碍,受伤,肯尼亚的传染性和非传染性疾病在过去5年中发布,直到2022年6月30日。研究选择和数据提取由三名独立审稿人完成,通过讨论或与高级审稿人解决了分歧。我们使用AGREEII工具的在线英文版在六个领域进行了质量评估。使用Stata软件V.17分析描述性统计数据。主要结果是通过AGREEII工具评分评估的纳入CPG的方法学质量。
筛选合格后,我们检索了95个CPG,并将24个纳入分析。CPG在表述清晰方面得分最高,在发展的严谨性方面得分最低。按降序排列,每个领域的评估得分(平均值和CI)如下:陈述清晰度为82.96%(95%CI为78.35%~87.57%),所有指南得分均在50%以上.范围和目的61.75%(95%CI54.19%至69.31%),7项指南评分低于50%。利益相关者参与45.25%(95%CI40.01%至50.49%),16个CPG得分低于50%。适用性领域19.88%(95%CI13.32%至26.43%),只有一个CPG评分高于50%。编辑独立性6.92%(95%CI3.47%至10.37%),无CPG评分高于50%,严格发展为3%(95%CI0.61%至5.39%),无CPG评分至少为50%。
我们的研究结果表明,肯尼亚CPG的质量主要受到发展的严谨性限制,编辑独立性,适用性和利益相关者参与。需要在指南开发人员中进行基于证据的方法的培训计划,以提高CPG的整体质量,以改善患者护理。
To assess the quality of available and accessible national Clinical Practice
Guidelines (CPGs) in Kenya using the Appraisal of
Guidelines for Research and Evaluation II (AGREE II) tool.
We searched the websites of the Kenyan Ministry of Health, professional associations and contacted experts in relevant organisations. Our scope was
guidelines on maternal, neonatal, nutritional disorders, injuries, communicable and non-communicable diseases in Kenya published in the last 5 years until 30 June 2022. Study selection and data extraction were done by three independent reviewers with disagreements resolved via discussion or with a senior reviewer. We conducted a quality assessment using the online English version of AGREE II tool across six domains. Descriptive statistics were analysed using Stata software V.17. The primary outcome was the methodological quality of the included CPGs assessed by the AGREE II tool score.
We retrieved 95 CPGs and included 24 in the analysis after screening for eligibility. The CPGs scored best in clarity of presentation and least in the rigour of development. In descending order, the appraisal scores (mean and CI) per domain were as follows: Clarity of presentation 82.96% (95% CI 78.35% to 87.57%) with all guidelines scoring above 50%. Scope and purpose 61.75% (95% CI 54.19% to 69.31%) with seven
guidelines scoring less than 50%. Stakeholder involvement 45.25% (95% CI 40.01% to 50.49%) with 16 CPGs scoring less than 50%. Applicability domain 19.88% (95% CI 13.32% to 26.43%) with only one CPG scoring above 50%. Editorial independence 6.92% (95% CI 3.47% to 10.37%) with no CPG scoring above 50% and rigour of development 3% (95% CI 0.61% to 5.39%) with no CPG scoring at least 50%.
Our findings suggest that the quality of CPGs in Kenya is limited mainly by the rigour of development, editorial independence, applicability and stakeholder involvement. Training initiatives on evidence-based methodology among
guideline developers are needed to improve the overall quality of CPGs for better patient care.