基于AGREE-HS评价的应急卫生系统指南特点  

Characteristics of Emergency Health Systems Guidance Based on AGREE-HS

作　　者：郑丹平 杨伟[1] 史楠楠[1] 卫东锋[1] 李安 张格知 陈雪 刘芳绮 闫兆帅 柏伟宣 向兴华 田雅欣 刘孟宇[1] 张华敏[2] ZHENG Danping;YANG Wei;SHI Nannan;WEI Dongfeng;LI An;ZHANG Gezhi;CHEN Xue;LIU Fangqi;YAN Zhaoshuai;BAI Weixuan;XIANG Xinghua;TIAN Yaxin;LIU Mengyu;ZHANG Huamin(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;School of Traditional Chinese and West ern Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Mathematics and Physics,North China Electric Power University,Baoding 071003,China)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]中国中医科学院中医基础理论研究所,北京100700 [3]甘肃中医药大学中西医结合学院,兰州730000 [4]华北电力大学数理系,河北保定071003

出　　处：《中国实验方剂学杂志》2024年第22期137-148,共12页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中国中医科学院科技创新工程项目(CI2021A00701-2);中国中医科学院自主选题项目(Z0740);国家自然科学基金面上项目(61771491)。

摘　　要：该研究采用卫生系统指南研究与评估系统(AGREE-HS)工具,对遴选的全球34份新型冠状病毒感染(COVID-19)应急卫生系统指南和6份世界卫生组织(WHO)标准卫生系统指南进行了示范性评价,评价条目包括主题、参与人员、方法、推荐意见和可实施性,旨在探索分析应急卫生系统指南的制定特点。评价结果显示,应急卫生系统指南的总体得分为49%,其中“主题”得分最高,“推荐意见”次之,“参与人员”得分最低;标准卫生系统指南的总体得分为79%,所有条目得分均较高。与标准卫生系统指南比较,应急卫生系统指南的“参与人员”“方法”“推荐意见”和“可实施性”得分显著降低(P<0.01),由WHO制定的COVID-19应急卫生系统指南在“主题”评分上优于标准卫生系统指南(P<0.05)。与各国家制定的COVID-19应急卫生系统指南比较,WHO指南在各条目和总体得分上均表现出显著优势(P<0.01)。分析表明,以COVID-19指南为代表的应急卫生系统指南与标准卫生系统指南同样重视主题和推荐意见,前者对制定专家参与度、证据依据充分性、综合考量全面性的要求有所弱化,具有突出主题、制定目的明确、围绕需求导向、紧跟最新证据、灵活调整、确保指南时效性,强调即时实施效果、弱化远期影响、注重综合效益等特点。此外,制定主体、指南类型及报告完整度是重要的影响因素。This study used the Appraisal of Guidelines Research&Evaluation-Health Systems(AGREE-HS)to demonstratively compare 34 global coronavirus disease-2019(COVID-19)health systems guidance documents(HSGs)and 6 World Health Organization(WHO)standard HSGs.The comparison involved topic,participants,methods,recommendations,and implementability,with the aim of exploring the characteristics of emergency HSGs.The results showed that the emergency HSGs had an overall average score of 49%,with topic having the highest score,recommendations having the second highest score,and participants having the lowest score.The standard HSGs had an overall average score of 79%,with high scores in all items.The emergency HSGs had lower scores in participants,methods,recommendations,and implementability than the standard HSGs(P<0.001),while the COVID-19 emergency HSGs developed by the WHO had higher score in topic than the standard HSGs(P<0.05).Compared with those released by countries,the COVID-19 emergency HSG developed by the WHO showed superiority in all items and overall scores(P=0.0002).This indicates that emergency HSGs,represented by the COVID-19 emergency HSG,place equal emphasis on topic and recommendations as standard HSGs but have low requirements in terms of expert participation,evidence support,and comprehensive consideration in the time-and resource-limited context.They have the characteristics of prominent topics,clear purposes,orientation to demand,keeping up with the latest evidence,flexible adjustment,and timeliness,emphasizing immediate implementation effects,weakening long-term effects,and focusing on comprehensive benefits.Additionally,developers,types,and report completeness are important influencing factors.

关 键 词：应急卫生系统指南 卫生系统指南研究与评估系统(AGREE-HS) 评价 公共卫生事件 

分 类 号：R2-031[医药卫生—中西医结合] R932[医药卫生—中医学] R256.35R442.2R288