2013-2014年度高血压临床指南的现状分析及循证临床指南评价  

Analysis on the status of 2013-2014 world's hypertension clinical guidelines and evaluation on evidence-based guidelines with AGREE instrument

作　　者：何伟[1] 唐海沁[1] 蒋品[1] 张亚文[1] 张勇[1] 

机构地区：[1]安徽医科大学第一附属医院老年心内科,合肥230022

出　　处：《中国临床保健杂志》2015年第3期238-243,共6页Chinese Journal of Clinical Healthcare

基　　金：安徽省科研计划项目(12010402116);安徽省卫生厅科技项目(13FR028)

摘　　要：目的调查分析2013-2014年国内外公布的新版高血压临床指南,采用AGREEⅡ工具评价高血压防治指南质量,为我国高血压临床指南的制定提供参考。方法计算机检索CNKI、Wanfang Data、Pub Med、Medline及相关机构认可和授权的网站,收集2013-2014年国内外公开发表的高血压临床指南,及2009至2014年国内外公开发表的高血压防治临床指南相关资料,按照纳入和排除标准筛选文献。描述性分析纳入指南名称、发表年份、机构、开发方法、参考文献数目等内容。采用AGREEⅡ工具评价2013-2014年国内外新版高血压临床指南的质量。结果共纳入高血压防治临床指南10部。评价结果表明,2013-2014年国内外高血压临床指南在表达的清晰性上得分最高,平均得分83.6%;其次为范围和目的,平均得分79.2%;参与人员项平均得分65.8%;适用性平均得分63.6%;编辑的独立性平均得分63.3%;严谨程度平均得分最低,为60.1%。指南总体评估显示,欧洲2013版、加拿大2013版、中国2013版、2014 JNC8版、2014 ASH/ISH版、日本2014版、2013 AHA/ACC/CDC版为积极推荐使用的指南,法国2013版、印度2013版、2013中国RH指南为推荐使用的指南(尚需补充和改进),没有不推荐或不确定的指南。结论 2013-2014年国内外高血压防治指南总体质量较高,发展中国家制定的指南质量明显提高,但与目前公认的循证医学要求仍存在差距,指南制定方法尚需规范。而建立科学、规范、适合国情的临床指南制定和评价体系,同期公布多版本的成套临床指南,有利于临床指南的推广实施。Objective To investigate and analyze the latest edition of clinical guidelines of hypertension a-round the world,by using AGREEⅡ instrument to evaluate the quality of those guidelines and provide information for the clinical hypertension guidelines in China.Method Through using computer retrieval CNKI,Wanfang Data, PubMed,Medline and related institutions approved and authorized web site,to collect clinical guidelines of hyperten-sion which were published during 2009-2014,and screened literatures according to the integration and elimination standard.Names of the guidelines,year of publication,organizations,methodology of development and reference num-ber were descriptive analyzed.Results Ten guidelines were included.Clarity of 2013-2014 world ＇s hypertension guidelines came in with a leading 83.6% average with scope and purpose second at 79.2%,and followed by stake-holder Involvement 65.8%,applicability 63.6%,editorial independence 63.3%,rigour of development 60.1%.The assessment showed that 2013 ESH/ESC Guidelines,2013 Canadian Recommendations,2013 Chinese Guidelines,2014 JNC8,2014 ASH/ISH Guidelines,JSH 2014 and 2013 AHA /ACC /CDC Guidelines were positive recommended.The guideline of 2013 French,2013 Indian and 2013 Chinese RH were recommended with future improvements（Still need to supplement and improvement）.Conclusion 1.During 2013 -2014,the quality of world ＇s latest hypertension＆amp;nbsp;guidelines are high and the quality of developing country＇s guidelines are improving.However,based on evidence-based medicine,there still need further development.2.It is necessary to develop a clinical guidelines evaluation sys-tem which is more scientific,more-normalized and more locally adapted.

关 键 词：高血压 指南 循证医学 评价研究 

分 类 号：R544.1[医药卫生—心血管疾病]