Quality of Low Back Pain Guidelines Improved
Quality of Low Back Pain Guidelines Improved
复制标题
DOI：
10.1097/brs.0b013e3181b4d50d
复制
发表时间：
2009-11-01
期刊：
影响因子：
3
通讯作者：
van Tulder, Maurits
中科院分区：
文献类型：
--
作者：
Bouwmeester, Walter;van Enst, Annefloor;van Tulder, Maurits
研究设计。临床指南的系统回顾。目的。评估初级保健中急性和慢性腰痛 (LBP) 管理临床指南的方法学质量并比较其建议。背景数据摘要。 2004 年进行的指南评估得出的结论是，腰痛初级保健指南的制定过程的质量和透明度以及报告的一致性需要提高。目前，多项指南已经修订并发布了新的指南。我们评估了指南的质量是否有所提高。方法。自 2004 年以来发布的指南是通过在 MEDLINE、Cochrane Back Review Group 数据库、指南信息交换所、Google 中进行电子搜索并联系专家来选择的。指南的方法学质量由 2 位作者使用欧洲指南、研究和评估评估工具独立评估。此外，还比较了诊断和治疗建议。结果。其中包括十四条准则。总的来说，质量令人满意。该指南在清晰度和演示方面得分最高。由于缺乏对临床问题的描述，范围和目的的领域得分通常中等。利益相关者参与领域得分中等，主要是因为指南没有在目标用户中进行测试。得分普遍较低的领域是适用性和编辑独立性。四个指南在制定的严谨性方面得分较低，但其他指南在该领域得分较高。指南中对急性腰痛的诊断和治疗建议主要具有可比性，而对慢性腰痛的治疗建议差异很大。结论。与2004年的质量评估相比，指南的平均质量有所提高。然而，指南制定者仍应提高制定过程的质量透明度。特别是未来指南需要确保指南的适用性和编辑的独立性。
Study Design. Systematic review of clinical guidelines.Objective. To assess the methodological quality of clinical guidelines for the management of acute and chronic low back pain (LBP) in primary care and compare their recommendations.Summary of Background Data. A guideline evaluation performed in 2004 concluded that the quality and transparency of the development process and consistency in the reporting of primary care guidelines for LBP need to be improved. At present, several guidelines have been revised and new guidelines are published. We evaluated if the quality of guidelines has improved.Methods. Guidelines published since 2004 were selected by electronically searching in MEDLINE, Cochrane Back Review Group database, Guideline Clearing House, Google, and contacting experts. The methodological quality of the guidelines was assessed by 2 authors independently, using the Appraisal of Guidelines, Research, and Evaluation in Europe instrument. Also, the diagnostic and therapeutic recommendations were compared.Results. Fourteen guidelines were included. In general, the quality was satisfactory. The guidelines had best scores on clarity and presentation. The domain scores of scope and purpose were often moderate due to the absence of description of the clinical questions. The domain of stakeholder involvement scored moderate, mostly because guidelines were not tested among target users. Domains that had generally low scores were applicability and editorial independence. Four guidelines scored low on the rigor of development, but the other guidelines scored high on this domain.The diagnostic and therapeutic recommendations in the guidelines for acute LBP were mainly comparable while the recommendations for the management of chronic LBP varied widely.Conclusion. Compared to the quality assessment performed in 2004, the average quality of guidelines has improved. However, guideline developers should still improve the quality transparency of the development process. Especially the applicability of guidelines and the editorial independence need to be ensured in future guidelines.