背景:高质量,需要以系统评价为基础的良好报告的临床实践指南(CPGs)和共识声明(CSs).我们评估了用于乳腺癌(BC)治疗的CPGs和CSs的质量和报告。
方法:遵循协议注册(Prosperono:CRD42020164801),对BC治疗的CPGs和CSs进行了鉴定,没有语言限制,通过对书目数据库的系统搜索(MEDLINE,EMBASE,WebofScience,Scopus,CDSR)和2017年1月至2020年6月的在线资源(12个指南数据库和51个专业协会网站)。使用AGREEII(最高得分的百分比)评估总体质量并使用RIGHT(占35个项目的百分比)报告合规性的数据一式两份;审阅者同意率分别为98%和96%。
结果:有59份相关指导文件(43份CPG,16个CS),其中20人使用系统评价进行证据综合。中位总体质量为54.0%(IQR35.9-74.3),中位总体报告依从性为60.9%(IQR44.5-84.4)。质量与报告之间的相关性为0.9。与CS相比,CPGs具有更好的质量(55.4%vs44.2%;p=0.032)和报告(67.18%vs44.5%;p=0.005)。与主观证据分析方法相比,使用系统综述的指导文件质量较好(76.3%vs51.4%;p=0.001),报告质量较好(87.1%vs59.4%;p=0.001).
结论:BC治疗中CPGs和CSs的质量和报告是中等强度的。应使用系统评价来提高CPG和CSS的质量和报告。
BACKGROUND: High-quality, well-reported clinical practice
guidelines (CPGs) and
consensus statements (CSs) underpinned by systematic reviews are needed. We appraised the quality and reporting of CPGs and CSs for breast cancer (BC) treatment.
METHODS: Following protocol registration (Prospero no: CRD42020164801), CPGs and CSs on BC treatment were identified, without language restrictions, through a systematic search of bibliographic databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR) and online sources (12
guideline databases and 51 professional society websites) from January 2017 to June 2020. Data were extracted in duplicate assessing overall quality using AGREE II (% of maximum score) and reporting compliance using RIGHT (% of total 35 items); reviewer agreement was 98% and 96% respectively.
RESULTS: There were 59 relevant guidance documents (43 CPGs, 16 CSs), of which 20 used systematic reviews for evidence synthesis. The median overall quality was 54.0% (IQR 35.9-74.3) and the median overall reporting compliance was 60.9% (IQR 44.5-84.4). The correlation between quality and reporting was 0.9. Compared to CSs, CPGs had better quality (55.4% vs 44.2%; p = 0.032) and reporting (67.18% vs 44.5%; p = 0.005). Compared to subjective methods of evidence analysis, guidance documents that used systematic reviews had better quality (76.3% vs 51.4%; p = 0.001) and reporting (87.1% vs 59.4%; p = 0.001).
CONCLUSIONS: The quality and reporting of CPGs and CSs in BC treatment were moderately strong. Systematic reviews should be used to improve the quality and reporting of CPGs and CSs.