戊型肝炎病毒(HEV)是一种人畜共患疾病,人类HEV感染主要导致急性感染,并可在免疫受损个体中发展为慢性表现。在过去的十年里,已经制定了诊断和治疗HEV感染的指南。本研究旨在系统地评估目前诊断和治疗HEV感染的指南的质量。我们分析了指南质量和主要建议的差异,并探讨了这些差异的可能原因。
■搜索了2013年至2022年之间发布的指南,并使用选择标准确定研究。该研究使用“评估研究和评估指南”工具评估了纳入指南的质量,提取了指南中的主要建议,确定了支持建议的最高证据水平,并使用牛津循证医学中心分级系统对证据进行重新分类。
■最终分析中包括了七个指南。准则的质量差异很大。差异可能是由于缺乏外部专家造成的,在指南应用中没有考虑影响因素,以及缺乏对公众意见的考虑。对主要建议的异质性分析揭示了管理慢性HEV感染的算法存在差异,利巴韦林的剂量,以及支持主要建议的证据水平较低。
■指南质量和主要建议差异很大。指南开发人员和研究人员的改进将有助于更新和应用诊断和治疗HEV感染的指南。
UNASSIGNED: The hepatitis E virus (HEV) is a zoonotic disease, and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised individuals. Over the past decade, guidelines for diagnosing and treating HEV infection have been developed. This study aimed to systematically assess the quality of current guidelines for diagnosing and treating HEV infection, and we analyzed the differences in
guideline quality and primary recommendations and explored possible reasons for these differences.
UNASSIGNED: Guidelines published between 2013 and 2022 were searched, and studies were identified using selection criteria. The study assessed the quality of the included
guidelines using the Appraisal of
Guidelines for Research and Evaluation tool, extracted the primary recommendations in the guidelines, determined the highest level of evidence supporting the recommendations, and reclassified the evidence using the Oxford Centre for Evidence-Based Medicine grading system.
UNASSIGNED: Seven guidelines were included in the final analysis. The quality of the guidelines varied widely. The discrepancies may have been caused by the lack of external experts, the failure to consider influencing factors in
guideline application, and the lack of consideration of the public\'s opinion. Analysis of the heterogeneity in primary recommendations revealed differences in algorithms for managing chronic HEV infection, the dosage of ribavirin, and a low level of evidence supporting the primary recommendations.
UNASSIGNED: Guideline quality and primary recommendations vary considerably. Refinement by
guideline developers and researchers would facilitate updating and applying
guidelines for diagnosing and treating HEV infection.