急性肾损伤临床指南和共识的方法学质量评价  

Methodological quality evaluation of clinical guidelines and consensus for acute kidney injury

作　　者：曾嵘[1] 姚可盈 黄佳 谭雨晴 李晓彤 Zeng Rong;Yao Keying;Huang Jia;Tan Yuqing;Li Xiaotong(Department of Nephrology,The Second Hospital of Lanzhou University,Lanzhou 730030,China;The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,China;The Second Clinical Medical School,Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院肾内科,甘肃兰州730030 [2]西安交通大学第一附属医院,陕西西安710000 [3]兰州大学第二临床医学院,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2024年第1期67-75,共9页Journal of Lanzhou University（Medical Sciences）

基　　金：兰州大学校级创新创业资助项目(20220050108)。

摘　　要：目的对急性肾损伤临床指南和共识进行方法学质量评价和推荐意见汇总分析,为临床指南和共识制订提供理论依据。方法系统检索国内外指南相关数据库,检索时限为建库至2023年9月4日,采用指南研究与评价(AGREE)Ⅱ工具进行方法学质量评价,并对急性肾损伤治疗相关推荐意见进行汇总分析。结果本研究共纳入9篇指南和共识。AGREEⅡ六个领域的平均标准化得分依次为:范围和目的50.93%,参与人员43.83%,制订的严谨性40.39%,清晰性73.46%,应用性41.90%,编辑独立性49.07%。指南推荐评价结果为1篇“强推荐”,8篇“修订后推荐”。相关推荐意见主要包括内科药物治疗、辅助支持治疗和肾脏替代治疗。结论本研究所进行的方法学质量评价和推荐意见汇总分析可帮助临床医生快速全面掌握领域内的诊疗情况,为临床实践提供参考。相关人员在今后指南制订过程中,应注意在证据检索阶段明确证据筛选标准与证据评级;在形成推荐意见时提高证据与推荐意见的联系性,在制订推荐意见时应多考虑现实可行性和指南实施过程中可能遇到的促进或阻碍因素,以制订出全面、科学的临床指南。Objective To summarize and analyze the methodological quality appraisal and recommendations of guidelines and consensuses related to acute renal injury,so as to provide a theoretical basis for the formulation of localized guidelines.Methods The domestic and foreign guidelines related database were systematically searched,and the search time was from the establishment of the database to September 4,2023.AGREEⅡwas used to evaluate the methodological quality of the included guidelines,and the recommendations related to the treatment of acute renal injury were summarized and analyzed.Results A total of 9 guidelines and consensuses were included in this study.The average score of AGREEⅡin six fields was 50.93%for scope and purpose,43.83%for participants,40.39%for preciseness,73.46%for clarity,41.90%for applicability,and 49.07%for editorial independence.The appraisal result of the guideline recommendation was one"strong recommendation"and eight"revised recommendations".Relevant recommendations mainly included medical drug treatment,auxiliary support treatment and renal replacement treatment.Conclusion The methodological quality appraisal and recommendation summary analysis conducted in this study can help clinicians quickly and comprehensively grasp the diagnosis and treatment situation in the field,and provide necessary references for clinical practice.Relevant personnel should pay attention to clear evidence screening criteria and evidence rating in the evidence retrieval stage in formulating guidelines in the future.The link between evidence and recommendations should be improved when forming recommendations,and more consideration be given to practical feasibility and possible promoting or hindering factors in the implementation process of recommendations,so as to formulate comprehensive and scientific clinical guidelines.

关 键 词：急性肾损伤 临床指南 指南研究与评价Ⅱ工具 质量评价 

分 类 号：R692[医药卫生—泌尿科学]