International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation instrument
International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation instrument
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DOI：
10.1200/jco.2004.06.157
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发表时间：
2004-05-15
影响因子：
45.3
通讯作者：
Cluzeau, FA
中科院分区：
文献类型：
--
作者：
Burgers, JS;Fervers, B;Cluzeau, FA
目的描述不同国家制定的肿瘤学指南的质量。方法采用指南评价与研究与评价（AGREE）工具对13个国家的100份指南（包括32份肿瘤学指南）进行质量评价。该工具的标准分为六个质量领域：范围和目的、涉众参与、开发的严密性、清晰度和表示、适用性和编辑独立性。结果肿瘤指南的发展严谨性评分显著高于非肿瘤指南（42.2% vs 29.4%; P = 0.02）。特别是，系统的证据检索方法更常用（P = 0.01）；更清楚地描述了制定建议的方法（P = .02）；在制定建议时更常考虑健康益处、风险和副作用（P = .03）。尽管其他领域的标准化得分没有显著差异，但肿瘤学指南在测量所有相关专业群体的纳入（P = 0.05）、考虑患者观点（P = 0.04）和不同选择的呈现（P = 0.05）方面的得分明显更高。只有三个制定肿瘤学指南的组织在三个以上领域的标准化得分超过60%。结论临床实践指南（CPGs）的质量一般，但在某些领域，肿瘤指南似乎比其他指南质量更好。组织的经验可以解释某些项目的高分。应制订旨在提高准则质量的研究项目和培训。商定的工具可以为制定高质量cpg的共同开发方法中的步骤提供基础。(C) 2004年由美国临床肿瘤学会出版。
PurposeTo describe the quality of oncology guidelines developed in different countries.MethodsThe Appraisal of Guidelines and Research and Evaluation (AGREE) Instrument was used to assess the quality of 100 guidelines (including 32 oncology guidelines) from 13 countries. The criteria of the instrument are grouped into six quality domains: scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence.ResultsOncology guidelines had significantly higher scores on rigor of development than nononcology guidelines (42.2% v 29.4%; P = .02). In particular, systematic methods to search for evidence were more often used (P = .01); the methods for formulating the recommendations were more clearly described (P = .02); and health benefits, risks, and side effects were more often considered in formulating the recommendations (P = .03). Although the standardized scores for the other domains were not significantly different, the oncology guidelines had significantly higher scores for items measuring inclusion of all relevant professional groups (P = .05), consideration of patient views (P = .04), and presentation of different options (P = .05). Only three organizations producing oncology guidelines had standardized scores more than 60% for more than three domains.ConclusionThe quality of clinical practice guidelines (CPGs) is modest in general, but for certain domains, oncology guidelines seem to be of better quality than others. The experience of the organization may explain higher scores for some items. Research projects and training aimed at improving the quality of guidelines should be developed. The AGREE instrument could provide a basis for defining steps in a shared development approach to produce high-quality CPGs. (C) 2004 by American Society of Clinical Oncology.