Appraisal of International Guidelines for Cutaneous Melanoma Management using the AGREE II assessment tool.

Appraisal of International Guidelines for Cutaneous Melanoma Management using the AGREE II assessment tool.
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DOI:
10.1016/j.jpra.2021.11.002
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发表时间:
2022-03
期刊:
影响因子:
1.4
通讯作者:
Harrison CJ
Harrison CJ
中科院分区:
其他
文献类型:
--
作者:
Jacklin C;Tan M;Sravanam S;Harrison CJ

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新的黑色素瘤治疗背后的证据基础正在迅速积累。这一点不一定反映在当前的指导意见中。最近发表在JPRAS上的一份英国专家共识声明呼吁更新被广泛接受的2015年国家健康与护理卓越研究所(NICE)黑色素瘤指南(NG14)。我们的目的是将NG14的质量与此后发表的所有其他黑色素瘤指南进行比较。我们对PubMed、Medline和在线临床实践指南数据库进行了系统检索,以确定2015年7月29日至2021年8月23日期间发表的黑色素瘤指南,这些指南提供了辅助治疗、放疗、手术管理或随访护理的建议。三位作者使用研究和评估工具II(AGREE II)评估工具评估了已确定的指南的质量,该工具衡量了指南制定的六个领域。评定者间信度采用Kendall’s coefficient of concordance(W)进行评估。29个指南被纳入并被评价为具有极好的一致性(Kendall's W,总体指南评分为0.88,p<0.001)。总体而言,黑色素瘤指南在“范围和目的”和“表述清晰度”方面得分很高,但在“适用性”方面得分很低。NICE黑色素瘤指南(NG14)获得了最佳总体评分。自NG14发表以来,黑色素瘤治疗已经取得了进展,然而,NICE黑色素瘤指南比最近的替代品质量更高。2022年NG14的计划更新是有需求的。
The evidence base behind new melanoma treatments is rapidly accumulating. This is not necessarily reflected in current guidance. A recent UK-based expert consensus statement, published in JPRAS, has called for updates to the widely accepted 2015 National Institute for Health and Care Excellence (NICE) guideline for melanoma (NG14). We aimed to compare the quality of NG14 to all other melanoma guidelines published since. We conducted a systematic search of PubMed, Medline, and online clinical practice guideline databases to identify melanoma guidelines published between 29th July 2015 and 23rd August 2021 providing recommendations for adjuvant treatment, radiotherapy, surgical management, or follow-up care. Three authors independently assessed the quality of identified guidelines using the Appraisal of Guidelines for Research & Evaluation Instrument II (AGREE II) assessment tool, which measures six domains of guideline development. Inter-rater reliability was assessed by Kendall's coefficient of concordance (W). Twenty-nine guidelines were included and appraised with excellent concordance (Kendall's W for overall guideline score 0.88, p<0.001). Overall, melanoma guidelines scored highly in the domains of ‘Scope and purpose’ and ‘Clarity of presentation’, but poorly in the ‘Applicability’ domain. The NICE guideline on melanoma (NG14) achieved the best overall scores. Melanoma treatment has advanced since NG14 was published, however, the NICE melanoma guideline is of higher quality than more recent alternatives. The planned update of NG14 in 2022 is in demand.
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