Scientific evidence underlying the American College of Gastroenterology's clinical practice guidelines
Scientific evidence underlying the American College of Gastroenterology's clinical practice guidelines
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DOI：
10.1371/journal.pone.0204720
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发表时间：
2018-10-03
期刊：
影响因子：
3.7
通讯作者：
Vassar, Matt
中科院分区：
文献类型：
--
作者：
Meyer, Chase;Bowers, Aaron;Vassar, Matt
背景临床实践指南包含医生为患者确定最合适的护理的建议。这些指南系统地结合了科学证据和临床判断，最终形成了旨在优化患者护理的建议。国家方案小组中的建议得到了质量不同的证据的支持。我们的目标是调查美国胃肠病学会制定的临床实践指南，报告支持他们建议的证据水平，并确定可以通过进一步研究改进证据的领域。方法我们从美国胃肠病学会发布的39个临床实践指南中提取了1328条建议。一些临床实践指南在他们的建议中使用了不同的证据分类。为了使结果标准化，我们设计了一个统一的证据系统。结果在我们的研究中，总共调查了39个临床实践指南。它们总共提出了1328条建议。693项建议(52.2%)基于证据不足，表明证据或专家意见不足。在个别指南中，13/39(33.3%)没有基于高证据的建议。结论美国胃肠病学会提出的建议很少有高水平的证据支持。美国胃肠病学会提出的所有建议中，有一半以上是基于低质量的证据或专家意见。
BackgroundClinical practice guidelines contain recommendations for physicians to determine the most appropriate care for patients. These guidelines systematically combine scientific evidence and clinical judgment, culminating in recommendations intended to optimize patient care. The recommendations in CPGs are supported by evidence which varies in quality. We aim to survey the clinical practice guidelines created by the American College of Gastroenterology, report the level of evidence supporting their recommendations, and identify areas where evidence can be improved with additional research.MethodsWe extracted 1328 recommendations from 39 clinical practice guidelines published by the American College of Gastroenterology. Several of the clinical practice guidelines used the differing classifications of evidence for their recommendations. To standardize our results, we devised a uniform system for evidence.ResultsA total of 39 clinical practice guidelines were surveyed in our study. Together they account for 1328 recommendations. 693 (52.2%) of the recommendations were based on low evidence, indicating poor evidence or expert opinion. Among individual guidelines, 13/39 (33.3%) had no recommendations based on high evidence.ConclusionVery few recommendations made by the American College of Gastroenterology are supported by high levels of evidence. More than half of all recommendations made by the American College of Gastroenterology are based on low-quality evidence or expert opinion.