Quality assessment of clinical practice guidelines using the AGREE instrument in Japan: A time trend analysis
Quality assessment of clinical practice guidelines using the AGREE instrument in Japan: A time trend analysis
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日本使用 AGREE 仪器对临床实践指南进行质量评估：时间趋势分析
DOI：
10.1371/journal.pone.0216346
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发表时间：
2019
期刊：
影响因子：
3.7
通讯作者：
T. Hasegawa
中科院分区：
文献类型：
--
作者：
K. Seto;Kunichika Matsumoto;S. Fujita;T. Kitazawa;Rebeka Amin;Y. Hatakeyama;T. Hasegawa
背景临床实践指南（CPGs）是促进医疗卫生规范化、提高医疗质量的代表性方法。很少有研究调查一个国家出版的CPG质量随时间的变化。我们的目的是调查随着时间的推移，在CPG的发展，公共利益的医疗质量，医疗服务提供者的反应，这一利益的可用基础设施的背景下，CPG的质量的变化。方法使用日本版研究和评价指南评价（AGREE）I对2000年至2014年在日本发布的所有与循证医学（EBM）相关的CPG（n = 373）进行评价。此外，还分析了质量的时间趋势。使用基于CPG开发文献出版年份的截止点，将评价的CPG分为2008年之前（2008年之前）和2009年之后（2008年之后）出版的CPG。随后，我们在1）第一版CPG和第二版CPG以及2）患者版本CPG方面对这些组进行了比较。结果AGREE I所有六个领域的得分每年都在提高。第一版和第二版的CPG（n = 64）的比较表明，修订后的所有领域的分数显着提高。在2008年之前的组中，在三个领域（#2利益相关者参与，#3开发的严谨性和#4演示的清晰度）以及2008年之后的组中的所有领域都有显著改善。2008年前后两组患者的CPG比较显示，仅一个领域（#1范围和目的）的评分增加。结论发表的CPG数量一直在增加，CPG的质量，使用AGREE I工具进行评估，一直在提高。这些变化似乎受到社会基础设施改善的影响，例如CPG开发程序的出版，CPG编制方法培训的可用性以及CPG相关技能的增加。
Background Clinical practice guidelines (CPGs) are representative methods for promoting the standardization of healthcare and improvement of its quality. Few studies have investigated changes in the quality of CPGs published in a country over time. Our aim was to investigate changes in the quality of CPGs over time in the context of the available infrastructure for CPG development, public interest in healthcare quality, and healthcare providers’ responses to this interest. Methods All CPGs pertaining to evidence-based medicine (EBM) issued between 2000 and 2014 in Japan (n = 373) were evaluated using the Japanese version of the Appraisal of Guidelines for Research and Evaluation (AGREE) I. Additionally, time trends in quality were analyzed. Using a cut-off point based on the publication year of CPG development literature, the evaluated CPGs were classified into those published until 2008 (pre-2008) and those published since 2009 (post-2008). Subsequently, we compared these groups in terms of 1) first edition CPGs and its second editions, and 2) patients’ version of CPGs. Results Scores on all six domains of AGREE I improved each year. A comparison of the first- and second-edition of CPGs (n = 64) showed that scores on all domains improved significantly after revision. Significant improvement was observed in three domains (#2 stakeholder involvement, #3 rigor of development, and #4 clarity of presentation) in the pre-2008 group and in all domains in the post-2008 group. The comparison between the pre- and post-2008 groups in terms of CPGs for patients showed that the score increased in only one domain (#1 scope and purpose). Conclusions The number of published CPGs has been increasing and the quality of CPGs, as assessed using the AGREE I instrument, has been improving. These changes seem to be influenced by improvements in social infrastructure, such as the publication of CPG development procedures, availability of CPG preparation methodology training, and increase in CPG-related skills.