Quality varies across clinical practice guidelines for mammography screening in women aged 40-49 years as assessed by AGREE and AMSTAR instruments
Quality varies across clinical practice guidelines for mammography screening in women aged 40-49 years as assessed by AGREE and AMSTAR instruments
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DOI：
10.1016/j.jclinepi.2010.12.005
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发表时间：
2011-09-01
影响因子：
7.2
通讯作者：
Smith, M. E. Beth
中科院分区：
文献类型：
--
作者：
Burda, Brittany U.;Norris, Susan L.;Smith, M. E. Beth
目的：评估临床实践指南的质量，提供有关无症状乳房X线摄影筛查频率的建议。平均风险妇女40-49岁。研究和环境：我们搜索了2005年至2010年出版的《国家指南清算室和MEDLINE》。五位独立评估员对每个准则的质量及其基本证据的质量进行了评估研究和评估指南（同意）和评估多个系统审查（AMSTAR）工具的评估：批准了11个准则。十个引用了基本证据审查；两个引用了同一评论。三个评论的评分很好，一个是中等的，有5个评分质量较差。在对准则质量的总体评估中，强烈建议使用两个，建议使用Provisos，而不建议使用七个，或者评估人员不确定是否建议。大多数准则清楚地提出了他们的建议，但是发展，适用性和利益相关者参与的严格性各不相同。七个指南建议将乳房X线摄影筛查作为定期健康检查的一部分，并在目标人群中进行了4项个性化筛查。后四个指南基于良好的评论，评估人员建议三个指南。判断：指南用户需要了解质量的可变性，并确定满足其需求的高质量指南。 （c）2011 Elsevier Inc.保留所有权利。
Objective: To assess the quality of clinical practice guidelines providing recommendations on the frequency of mammography screening in asymptomatic. average-risk women 40-49 years of age.Study Design and Setting: We searched the National Guideline Clearinghouse and MEDLINE for guidelines published from 2005 to 2010. Five independent assessors rated the quality of each guideline and its underlying evidence review using the Appraisal of Guidelines for Research and Evaluation (AGREE) and Assessment of Multiple Systematic Reviews (AMSTAR) instruments, respectively.Results: Eleven guidelines were appraised. Ten referenced an underlying evidence review; two referenced the same review. Three reviews were rated good, one was moderate, and five were rated poor quality. On overall assessment of the quality of the guidelines, two were strongly recommended, two were recommended with provisos, and seven were either not recommended or the assessors were unsure whether to recommend it. Most guidelines clearly presented their recommendations, but the rigor of development, applicability, and stakeholder involvement varied. Seven guidelines recommended mammography screening as part of a periodic health examination and four recommended individualized screening in the target population. The latter four guidelines were based on good-quality reviews and three were recommended by the assessors.Conclusion: Guideline users need to be aware of the variability in quality and identify the high-quality guidelines that meet their needs. (C) 2011 Elsevier Inc. All rights reserved.