上海交通大学学报(医学版)

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双相障碍临床指南的评价研究

万玉美1,李 伟1,胡 强1,钱 洁2,李 婷1,吴志国1,方贻儒1,李春波1   

  1. 1.上海交通大学 医学院附属精神卫生中心  上海市重性精神病重点实验室, 上海 200030; 2.同济大学附属杨浦医院临床心理科, 上海 200090
  • 出版日期:2014-04-28 发布日期:2014-05-13
  • 通讯作者: 李春波, 电子信箱: chunbo_li@yahoo.com。
  • 作者简介:万玉美(1987—), 女, 硕士; 电子信箱: wanyumei2011@163.com。
  • 基金资助:

    “十二五”国家科技支撑项目(2012BAI01B00);上海市卫生系统优秀学科带头人培养计划(XBR2011005)

Study on evaluation of clinical guidelines of bipolar disorder

WAN Yu-mei1, LI Wei1, HU Qiang1, QIAN Jie2, LI Ting1, WU Zhi-guo1, FANG Yi-ru1, LI Chun-bo1   

  1. 1.Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2.Department of Clinical Psychology, Shanghai Yangpu District Central Hospital, Tongji University, Shanghai 200090, China
  • Online:2014-04-28 Published:2014-05-13
  • Supported by:

    the “12th Five-year Plan” of National Key Technologies R&D Program, 2012BAI01B00; Shanghai Medical Excellent Discipline Leader Training Program, XBR2011005

摘要:

目的 运用指南研究与评价Ⅱ (AGREEⅡ)工具评价国内外双相临床指南的方法学质量。方法 以“双相障碍(bipolar disorder)”“临床指南(clinical guideline)”等为检索词,通过计算机检索中国知识资源总库、中国科技期刊数据库、万方数据检索系统、中国生物医学文摘数据库、PubMed、OVID、BMJ Best Practice、Dynamed、ISI Web of Knowledge、美国国家指南交换库(NGC)以及国际指南网络(G-I-N)等网站,并辅以手动检索,收集国内外符合该研究标准的临床指南。依据AGREEⅡ工具,对其方法学质量进行评价。结果 共纳入17个双相障碍临床指南。AGREEⅡ标准化总体得分显示:陈述清晰性(83%)、范围和目的(69%)领域较高,开发严谨性(40%)和参与人员(31%)领域次之,编辑独立性(25%)和应用性(15%)领域最低。循证指南在开发严谨性、陈述清晰性、应用性、参与人员以及范围和目的5个领域的得分均高于专家共识指南。中国双相障碍防治指南在编辑独立性领域得分为0,低于其他14个循证指南的总体得分。结论 纳入的双相障碍临床指南总体质量与AGREEⅡ标准差距较大。建议今后指南开发制定或更新过程中更多采用AGREEⅡ工具作为参考。

关键词: 双相障碍, 临床指南, 质量评价, 卫生保健, 文献计量学, 指南研究与评价Ⅱ

Abstract:

Objective To evaluate the quality of methodologies of clinical guidelines on the bipolar disorder by using the Appraisal of Guidelines for Research and Evaluation (AGREEⅡ). Methods Clinical guidelines from home and abroad that met the study criteria were retrieved from the Chinese National Knowledge Infrastructure, Chongqing VIP database for Chinese Technical Periodicals, WANFANG DATA, Chinese Biological Medical Literature Database, PubMed, OVID, BMJ Best Practice, Dynamed, ISI Web of Knowledge, National Guideline Clearinghouse (NGC), Guidelines International Network (G-I-N), Scottish Intercollegiate Guidelines Network (SIGN), and other related websites. Search words were bipolar disorder and clinical guideline. The quality of methodologies of these clinical guidelines was evaluated based on the AGREEⅡ. Results Seventeen clinical guidelines were selected. The overall median domain scores of AGREEⅡ showed that the bestperforming domains were clarity of presentation (83%) and scope and purpose (69%), and followed by rigour of development (40%) and stakeholder involvement (31%). Editorial independence (25%) and applicability (15%) got the lowest scores. The scores of rigour of development, clarity of presentation, applicability, stakeholder involvement and scope and purpose of the evidence-based guidelines were higher than those of the expert consensus guidelines. The score of editorial independence of Chinese guideline on prevention and treatment of bipolar disorder was zero and its scores were lower than the overall median scores of other fourteen evidence-based guidelines. Conclusion The overall quality of methodologies of evaluated clinical guidelines on bipolar disorder cannot meet the criteria of AGREE Ⅱ. AGREE Ⅱ is recommended to be used to develop and update the clinical guidelines.

Key words: bipolar disorder, clinical guideline, quality appraisal, health care, bibliometrics, Appraisal of Guidelines for Research and Evaluation Ⅱ