背景:口腔疾病是全球主要的公共卫生问题,影响受影响者的生活质量。虽然对高质量的重要性存在共识,循证指南,为医学实践和公共卫生决策提供信息,口腔健康指南的生产者通常不遵守适当的方法和标准。本研究旨在系统地确定在全球范围内制定口腔健康循证指南的组织,并调查制定建议所遵循的方法学过程。
方法:我们搜索了许多电子数据库,指南库,和指南开发者的网站,科学社会,和国际组织(2012年1月至2023年10月),以确定制定针对任何口腔健康主题的指南并明确宣布在其制定中纳入研究证据的组织。成对的评审员根据预定义的选择标准和提取的有关组织特征的数据,独立评估潜在合格的组织,他们指南的关键特征,以及在制定正式建议时遵循的过程。描述性统计用于分析和总结数据。
结果:我们纳入了46个制定口腔健康循证指南的组织。这些组织主要是专业协会和科学学会(67%),其次是政府组织(28%)。总的来说,组织制作了55种不同的指导方针文件类型,其中大多数包含临床实践建议(77%)。小组主要由医疗保健专业人员(87%)组成,其次是研究方法学家(40%),决策者(24%),和患者伴侣(18%)。大多数(60%)的指南报告了他们的资金来源,但只有三分之一(33%)包括利益冲突(COI)政策管理。55种准则文件中使用的方法因组织而异,但只有19个(35%)包含正式建议。一半(51%)的准则文件提到了方法论手册,46%的人建议采用结构化的方法或系统来评估证据的确定性和建议的强度,37%的人提到使用框架从证据转向决策,GRADE-EtD是使用最广泛的(27%)。
结论:我们的发现强调了口腔健康指南中使用的术语和方法与当前国际标准的一致性和标准化的必要性,以制定值得信赖的建议。
BACKGROUND: Oral diseases are a major global public health problem, impacting the quality of life of those affected. While consensus exists on the importance of high-quality, evidence-informed guidelines to inform practice and public health decisions in medicine, appropriate methodologies and standards are not commonly adhered to among producers of oral health guidelines. This study aimed to systematically identify organizations that develop evidence-informed guidelines in oral health globally and survey the methodological process followed to formulate
recommendations.
METHODS: We searched numerous electronic databases, guideline repositories, and websites of guideline developers, scientific societies, and international organizations (January 2012-October 2023) to identify organizations that develop guidelines addressing any oral health topic and that explicitly declare the inclusion of research evidence in their development. Pairs of reviewers independently evaluated potentially eligible organizations according to predefined selection criteria and extracted data about the organization\'s characteristics, key features of their guidelines, and the process followed when formulating formal
recommendations. Descriptive statistics were used to analyze and summarize data.
RESULTS: We included 46 organizations that developed evidence-informed guidelines in oral health. The organizations were mainly professional associations and scientific societies (67%), followed by governmental organizations (28%). In total, organizations produced 55 different guideline document types, most of them containing
recommendations for clinical practice (77%). Panels were primarily composed of healthcare professionals (87%), followed by research methodologists (40%), policymakers (24%), and patient partners (18%). Most (60%) of the guidelines reported their funding source, but only one out of three (33%) included a conflict of interest (COI) policy management. The methodology used in the 55 guideline document types varied across the organizations, but only 19 (35%) contained formal
recommendations. Half (51%) of the guideline documents referred to a methodology handbook, 46% suggested a structured approach or system for rating the certainty of the evidence and the strength of
recommendations, and 37% mentioned using a framework to move from evidence to decisions, with the GRADE-EtD being the most widely used (27%).
CONCLUSIONS: Our findings underscore the need for alignment and standardization of both terminology and methodologies used in oral health guidelines with current international standards to formulate trustworthy recommendations.