The quality of clinical practice guidelines for management of pediatric type 2 diabetes mellitus: a systematic review using the AGREE II instrument.
The quality of clinical practice guidelines for management of pediatric type 2 diabetes mellitus: a systematic review using the AGREE II instrument.
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DOI：
10.1186/s13643-018-0843-1
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发表时间：
2018-11-15
影响因子：
3.7
通讯作者：
Samaan MC
中科院分区：
文献类型：
--
作者：
Bhatt M;Nahari A;Wang PW;Kearsley E;Falzone N;Chen S;Fu E;Jeyakumar Y;Zukowski J;Banfield L;Thabane L;Samaan MC
儿童2型糖尿病(T2 DM)是一种相对较新的疾病，与青少年肥胖流行相对应，发病率呈上升趋势。对于临床医生来说，获得高质量的临床实践指南(CPGs)对于适当地处理儿童T2 DM患者是很重要的。这项系统性综述的目的是使用研究和评估指南评估II(Agree II)工具来评估CPG在儿童T2 DM治疗中的整体质量。我们搜索了MEDLINE、Embase、CINAHL、TRIP、国家指南信息中心和灰色文献，以确定符合条件的CPG。我们还搜索了全球国内和国际糖尿病和儿科组织的网页。我们纳入了国家和国际糖尿病和儿科协会的CPG，这些CPG作为儿童和青少年(2-18岁)T2 DM的独立指南出版。我们还包括儿童和成人1型糖尿病指南，如果它们包括儿童和青少年T2 DM管理的部分。我们从每个组织检索了两个最新的指南，以评估随着时间的推移在质量方面的变化。我们排除了提出治疗建议的个别研究和系统评价，以及为单一机构开发的CPG。我们在这项系统审查中纳入了21个独特的CPG。在纳入的指南中，有12项是在2012至2014年间制定或更新的。所有纳入的CPG中有5个是专用于儿科人群的。分析显示，就大部分指南而言，“发展的严谨性”(平均45%，SD 28.68)和“编辑独立性”(平均45%，SD 35.19)是评分最低的领域，而“陈述的清晰度”是得分最高的领域(平均72%，SD 18.89)。总体而言，三分之二的儿科T2 DM指南是中等到低质量，其余三分之一的质量排名较高。低质量尤其是由于“发展的严格性”领域的分数，该领域直接衡量指导方针开发方法。重要的是，未来的指南和现有指南的更新应改进开发方法和报告质量，以便适当指导治疗儿童和青少年2型糖尿病的医生。PROSPERO CRD42016034187本文的在线版本(10.1186/s13643-0180843-1)包含补充材料，授权用户可以使用。
Pediatric type 2 diabetes mellitus (T2DM) is a relatively new disease with increasing incidence corresponding to the obesity epidemic among youth. It is important for clinicians to have access to high-quality clinical practice guidelines (CPGs) for appropriate management of pediatric patients with T2DM. The objective of this systematic review was to evaluate overall quality of CPGs for the management of pediatric T2DM using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. We searched MEDLINE, Embase, CINAHL, Trip, National Guideline Clearinghouse, and grey literature to identify eligible CPGs. We also searched the webpages of national and international diabetes and pediatric organizations globally. We included CPGs from national and international diabetes and pediatric associations that were published as standalone guidelines for T2DM in children and adolescents (2–18 years of age). We also included pediatric and adult guidelines for type 1 diabetes if they included a section addressing T2DM management in children and adolescents. We retrieved the two most recent guidelines from each organization when available to assess change in quality over time. We excluded individual studies and systematic reviews that made treatment recommendations as well as CPGs that were developed for a single institution. We included 21 unique CPGs in this systematic review. Of the included guidelines, 12 were developed or updated between 2012 and 2014. Five of all included CPGs were specific to pediatric populations. The analysis revealed that “Rigour of Development” (mean 45%, SD 28.68) and “Editorial Independence” (mean 45%, SD 35.19) were the lowest scoring domains on the AGREE II for the majority of guidelines, whereas “Clarity of Presentation” was the highest scoring domain (mean 72%, SD 18.89). Overall, two thirds of the pediatric T2DM guidelines were moderate to low quality and the remaining third ranked higher in quality. Low quality was especially due to the scores for the “Rigour of Development” domain, which directly measures guideline development methodology. It is important that future guidelines and updates of existing guidelines improve the methodology of development and quality of reporting in order to appropriately guide physicians managing children and adolescents with T2DM. PROSPERO CRD42016034187 The online version of this article (10.1186/s13643-018-0843-1) contains supplementary material, which is available to authorized users.
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影响因子：
39.2
作者：
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影响因子：
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影响因子：
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影响因子：
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