基于AGREE Ⅱ的中医/中西医结合慢性肾脏病诊疗指南质量评价  

A guideline quality evaluation for the diagnosis and treatment of chronic kidney diseases in traditional Chinese medicine/integrated Chinese and Western medicine based on AGREE Ⅱ

作　　者：熊敏[1,2] 周静威[1] 戴宁[2] 刘雪寒[2] 薛雪 刘建平[2] XIONG Min;ZHOU Jingwei;DAI Ning;LIU Xuehan;XUE Xue;LIU Jianping(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Centre for Evidence-Based Chinese Medicine of Beijing University of Chinese Medicine;First Clinical College of Hubei University of Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学循证医学中心 [3]湖北中医药大学第一临床医学院

出　　处：《现代中医临床》2022年第6期50-58,共9页Modern Chinese Clinical Medicine

基　　金：国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-C-202006)。

摘　　要：目的 系统评价中医/中西医结合慢性肾脏病诊疗指南的方法学质量,为指南更新和推广提供依据。方法 系统检索国内期刊发表的中医/中西医结合慢性肾脏病诊疗指南,提取和总结特征信息,运用AGREEⅡ对表达的明晰性、范围与目的、参与人员、制定严谨性、编辑独立性和应用性等6个领域进行独立质量评价,将评分结果按年份、机构、开发方法、基金资助等因素进行分层分析,并结合已发表的国内外其他病种领域指南的AGREEⅡ评价结果进行横向比较。结果 共纳入19部相关指南,其中:中医指南2部,中西医结合指南17部,涉及“慢性肾衰竭”“IgA肾病”等疾病;16部为学会制定,1部为更新修订版本,4部采用循证医学方法制定,8部指南提及科研基金资助;颁布年份跨度为2008年至2020年,3部为近5年内制定。AGREEⅡ总体评分中表达的明晰性(52.63%)、范围与目的(42.4%)两个领域得分较高,参与人员得分(24.27%)次之,制定严谨性(19.19%)、编辑独立性(18.42%)、应用性(7.24%)三个领域得分非常低,5部(26.31%)指南被评价者“推荐使用”;分层分析中新近制定、采用循证医学方法开发流程、报告科研基金资助的指南AGREEⅡ评分相对较高;与相关研究结果横向比较,慢性肾脏病领域与国内心血管领域的中医/中西医指南的AGREE II评分相当,但与国际上发表指南的抽样AGREE II评价结果相差较大。结论 我国中医/中西医结合慢性肾脏病诊疗指南AGREEⅡ评分总体较低,应更加重视循证开发的方法学原则,特别是在制定人员组成、技术流程的严谨性、利益冲突和应用性等方面提升指南质量。Objective To systematically evaluate the methodological quality of the guidelines for the diagnosis and treatment of chronic kidney diseases in traditional Chinese medicine/integrated traditional Chinese and Western medicine, so as to provide a basis for further update and promotion of the guidelines.Methods Systematical search was performed of the traditional Chinese medicine/integrated Chinese and Western medicine guidelines for chronic kidney diseases diagnosis and treatment published by Chinese journals. The information about their characteristics were extracted and summarized. Then AGREE Ⅱ was used in independent quality evaluations in six aspects including clarity of expression, scope and purpose, participants, rigor, editorial independence, and applicability. The scoring results are analyzed in layers based on the year of their publication, institution, development method, and whether they are funded or not, and are horizontally compared with the published AGREE Ⅱ evaluation results of guidelines for other diseases at home and abroad.Results A total of 19 guidelines were included, of which: 2 guidelines for traditional Chinese medicine, 17 guidelines for integrated traditional Chinese and western medicine, covering diseases such as chronic renal failure and IgA nephropathy;16 were formulated by academic societies, and 1 was an updated and revised version, 4 were formulated using evidence-based medicine methods, and 8 guidelines received research funding;the guidelines were issued from 2008 to 2020, and 3 were formulated within the past 5 years. In the overall AGREE Ⅱ score, the clarity of expression(52.63%), scope and purpose(42.4%) scored higher, followed by the score of participants(24.27%). Rigor(19.19%), editorial independence(18.42%), and applicability(7.24%) scores were very low, and 5 guidelines(26.31%) were “recommended for use” by the evaluators;In the stratified analysis, it was found that the AGREE Ⅱ scores of the three types of guides were relatively high: recently developed guideli

关 键 词：慢性肾脏病 中医 中西医结合 指南 质量评价 AGREEⅡ 

分 类 号：R2-03[医药卫生—中医学]