Critical evaluation of the scientific content in clinical practice guidelines.
Critical evaluation of the scientific content in clinical practice guidelines.
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DOI：
10.1002/cncr.29124
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发表时间：
2015-03-01
期刊：
影响因子：
6.2
通讯作者：
Wong, Sandra L.
中科院分区：
文献类型：
--
作者：
Abdelsattar, Zaid M.;Reames, Bradley N.;Regenbogen, Scott E.;Hendren, Samantha;Wong, Sandra L.
提供高质量循证癌症护理的压力越来越大，推动了临床实践指南（CPG）的快速增长。CPG的质量和有效性受到质疑，对指南的遵守率相对较低。本研究的目的是批判性地评估CPGs的发展过程和科学内容。评价了解决直肠癌管理的CPG。我们用经过验证的指南研究与评价评估（AGREE II）工具定量评估指南质量。我们确定了21个独立的护理过程中使用的名义组技术。然后，我们比较了这些护理过程的管理建议的证据基础和科学协议。直肠癌CPG的质量和含量差异很大。平均总体AGREE II评分范围为27- 90%。在5个CPG中，表述清晰度的平均得分最高（85%，范围58%至99%），适用性领域的平均得分最低（21%，范围8%至56%）。随机对照试验引用的比例很小（中位数18%，范围13-35%），78%的建议基于低或中等质量的证据，CPG与最高评级的CPG只有11篇参考文献。在评估的21个护理过程中，有13个（62%）的建议相互矛盾。CPG的开发过程和科学内容有很大的差异。由于CPG之间的建议相互矛盾，因此没有可靠的资源来指导高质量的循证癌症护理。CPG的质量和一致性需要改进。
Increasing pressures to provide high quality evidence-based cancer care have driven the rapid proliferation of clinical practice guidelines (CPGs). The quality and validity of CPGs have been questioned and adherence to guidelines is relatively low. The purpose of this study is to critically evaluate the development process and scientific content of CPGs. CPGs addressing management of rectal cancer were evaluated. We quantitatively assessed guideline quality with the validated Appraisal of Guidelines Research & Evaluation (AGREE II) instrument. We identified 21 independent processes of care using the Nominal Group Technique. We then compared the evidence base and scientific agreement for the management recommendations for these processes of care. The quality and content of rectal cancer CPGs varied widely. Mean overall AGREE II scores ranged from 27–90%. Across the five CPGs, average scores were highest for the clarity of presentation domain (85%, range 58% to 99%) and lowest for the applicability domain (21%, range 8% to 56%). Randomized controlled trials represented a small proportion of citations (median 18%, range 13–35%), 78% of the recommendations were based on low or moderate quality evidence, and the CPGs only had 11 references in common with the highest rated CPG. There were conflicting recommendations for 13 of the 21 care processes assessed (62%). There is significant variation in CPG development processes and scientific content. With conflicting recommendations between CPGs, there is no reliable resource to guide high-quality evidence-based cancer care. The quality and consistency of CPGs are in need of improvement.
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影响因子：
--
作者：
Greenberg, Caprice C.;Lipsitz, Stuart R.;Weeks, Jane C.
通讯作者：
Weeks, Jane C.
DOI：
10.2105/ajph.62.3.337
发表时间：
1972-01-01
期刊：
AMERICAN JOURNAL OF PUBLIC HEALTH AND THE NATIONS HEALTH
影响因子：
--
作者：
VANDEVEN, AH;DELBECQ, AL
通讯作者：
DELBECQ, AL
影响因子：
168.9
作者：
Grilli, R;Magrini, N;Liberati, A
通讯作者：
Liberati, A
影响因子：
9
作者：
Monson, John R. T.;Probst, Christian P.;Dietz, David W.
通讯作者：
Dietz, David W.
影响因子：
158.5
作者：
Bosset, Jean-Francois;Collette, Laurence;Ollier, Jean-Claude
通讯作者：
Ollier, Jean-Claude