UASSIGNED:自2010年世界过敏组织(WAO)诊断和针对奶牛牛奶过敏(DRACMA)指南发布以来,许多其他指南,专家意见,与牛奶过敏(CMA)管理相关的立场文件已经发表。我们旨在系统回顾2010年至2020年期间发布的儿童和/或成人CMA诊断和管理指南的质量。
未经批准:MEDLINE,EMBASE,ISIWebofScience,世界卫生组织全球指数,从2010年1月至2020年5月,搜索了将研究转化为实践数据库以及网站指南存储库。包括由专业科学学会或组织制定或认可的任何针对儿童和/或成人CMA诊断和管理的临床实践建议和/或指南。使用评估研究和评估指南(AGREEII)工具对指南进行了评估,在6个域和2个全球评级项目中组织的23项工具。
UNASSIGNED:我们纳入了12个准则;8个由国家组织制定,4个由国际组织制定。每个域的质量分数各不相同:在所有域中,呈现域的清晰度中位数得分最高(92%;Q1-Q381-100%),而严格性发育的中位评分最低(30%;Q1-Q315-67%).单个领域的中位数得分(Q1-Q3)如下:范围和目的82%(70-99%),利益相关者参与63%(21-79%),发展的严谨性30%(15-67%),陈述清晰度92%(81-100%),适用性68%(57-75%),和编辑独立性75%(69-100%)。中位总分为70%(58-89%)。只有1个指南(来自美国国家健康与护理卓越研究所[NICE])在五个领域和总分中获得了最高评分(100%)。三个准则(来自NICE,英国过敏与临床免疫学会[BSACI]和WAO)在至少3个领域和总体评分中获得了最高的评分(100%)。
UASSIGNED:大多数确定的指南质量良好或非常好。然而,最薄弱的一点是发展领域的严谨性,主要是由于对证据的优势和局限性以及更新指南的程序描述不清楚。
UNASSIGNED: Since the publication of The World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow\'s Milk Allergy (DRACMA)
Guidelines in 2010, a number of other
guidelines, expert opinions, and position papers relating to the management of cow\'s milk allergy (CMA) have been published. We aimed to systematically review the quality of the guidelines on CMA diagnosis and management in children and/or adults published between 2010 and 2020.
UNASSIGNED: The MEDLINE, EMBASE, ISI Web of Science, World Health Organization Global Index Medicus, and Turning Research into Practice databases as well as website
guideline repositories were searched from January 2010 until May 2020. Any clinical practice recommendations and/or guidelines focusing on the diagnosis and management of CMA in children and/or adults developed or endorsed by professional scientific societies or organizations were included. The
guidelines were evaluated using the Appraisal of
Guidelines for Research and Evaluation (AGREE II) tool, a 23-item tool organized within 6 domains and 2 global rating items.
UNASSIGNED: We included 12 guidelines; 8 were developed by national and 4 by international organizations. The quality scores for each domain varied: of all domains, the clarity of presentation domain had the highest median score (92%; Q1-Q3 81-100%), whereas rigor of development had the lowest median score (30%; Q1-Q3 15-67%). The median scores (Q1-Q3) for individual domains were as follows: scope and purpose 82% (70-99%), stakeholder involvement 63% (21-79%), rigor of development 30% (15-67%), clarity of presentation 92% (81-100%), applicability 68% (57-75%), and editorial independence 75% (69-100%). The median overall score was 70% (58-89%). Only 1
guideline (from the National Institute for Health and Care Excellence [NICE]) achieved top ratings (100%) in five domains and the overall score. Three guidelines (from the NICE, the British Society for Allergy & Clinical Immunology [BSACI] and WAO) achieved the highest ratings (100%) in at least 3 domains and the overall score.
UNASSIGNED: The majority of identified guidelines were of good or very good quality. However, the weakest point was the rigor of development domain, mostly due to unclear description of strengths and limitations of the body of evidence and the procedure for updating the guidelines.