摘要
目的针对我国肾脏疾病临床实践指南进行评价,为遴选符合我国临床实际、高质量的肾脏疾病指南以及今后指南的规范化制定提供参考依据、提出改进建议。方法利用计算机及手工检索中国临床指南文库、中国生物医学文献数据库、维普数据库、万方数据库和中国知网等,检索起止时间为2013年1月至2018年7月。按照既定纳入和排除标准筛选公开发表的国内肾脏疾病指南,按照中国临床实践指南评价体系系统分析和评价我国肾脏疾病指南现状。结果共纳入18部国内肾脏疾病临床实践指南,涵盖肾小球肾炎、肾病综合征、终末期肾病等病种。总体得分范围为30~68分,平均得分为47.3分;在科学性/严谨性、有效性/安全性、经济性、可用性/可行性和利益冲突5个评价领域的平均得分分别为20.1分、12.8分、0.5分、9.9分和3.9分。其中,8部(44.4%)指南的整体印象评价为强推荐,10部(55.6%)指南为弱推荐。结论我国肾脏疾病指南在科学性/严谨性、经济性等方面存在不足,与循证指南的要求存在一定差距。中国临床实践指南评价体系可作为符合我国国情的指南评价工具,但是其实用性和可行性仍需进一步验证和完善。
Objective To evaluate the quality of clinical practice guidelines for kidney diseases in China and provide reference for selecting suitable high-quality guidelines for primary care and developing standardized guidelines.Methods The China Guideline Clearinghouse,China Biology Medicine disc,VIP Database,Wanfang Database and CNKI,and other resources were searched from January 2013 to July 2018.In accordance with the criteria for inclusion and exclusion,the published guidelines for kidney diseases were screened.The Appraisal of Guidelines Research and Evaluation-China(AGREE-China)was used to systematically assess the current status of domestic guidelines for kidney diseases.Results A total of 18 guidelines for kidney diseases were included,covering different types of kidney disease such as glomerulonephritis,nephrotic syndrome,end-stage renal disease and other diseases.The overall score ranged from 30 to 68,with an average score of 47.3.The average scores of these guidelines were 20.1,12.8,0.5,9.9 and 3.9 in five review fields including scientificity/rigorism,effectiveness/safety,economy,availability/feasibility,and conflicts of interest,respectively.Of these 18 guidelines,8(44.4%)guidelines were strongly recommended,and 10(55.6%)guidelines were weakly recommended.Conclusions There are still deficiencies in scientificity/rigorism and economy in current guidelines for kidney diseases in China.The AGREE-China can be used as an evaluation tool for guidelines for kidney diseases in accordance with China's situation,while its practicability and feasibility still need further verification and improvement.
作者
杨超
黄超
刘丽丽
陈睿
王晋伟
孟立强
张路霞
张宏
王强
吕继成
赵明辉
肾脏疾病临床实践指南评价遴选工作组
Yang Chao;Huang Chao;Liu Lili;Chen Rui;Wang Jinwei;Meng Liqiang;Zhang Luxia;Zhang Hong;Wang Qiang;Lyu Jicheng;Zhao Minghui;Evaluation and Selection of Clinical Practice Guidelines for Kidney Disease Working Group(Renal Division,Department of Medicine,Peking University First Hospital,Peking University Institute of Nephrology,Beijing 100034,China;National Center for Medical Service Administration,National Health Commission,Beijing 100044,China;National Institute of Health Data Science at Peking University,Beijing 100191,China;Peking-Tsinghua Center for Life Sciences,Beijing 100871,China;不详)
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2019年第12期929-936,共8页
Chinese Journal of Nephrology
基金
国家重点研发计划项目(2018YFC1314000)
国家卫生健康委员会医疗管理服务指导中心委托项目(2017-135、2018-83)。
关键词
肾疾病
循证医学
系统分析
临床实践指南
Kidney diseases
Evidence-based medicine
Systems analysis
Clinical practice guidelines
