基于AGREE Ⅱ评价急性心力衰竭临床实践指南的质量

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基于AGREE Ⅱ评价急性心力衰竭临床实践指南的质量

张方圆康晓凤韦丙奇吴海彤李峥

北京协和医学院护理学院

出版日期:2016-01-25 发布日期:2016-01-25

Quality appraisal of clinical practice guidelines for acute heart failure using AGREE II

Online:2016-01-25 Published:2016-01-25

摘要/Abstract

摘要： 目的：对国内外急性心力衰竭临床实践指南进行质量评价，以期为临床实践提供参考。方法：检索国内外文献数据库、指南数据库及网站，按照纳入和排除标准筛选指南；使用AGREE Ⅱ评估工具对指南进行质量评价并通过组内相关系数对评价者间总的一致性进行评价。结果：共纳入7 篇急性心力衰竭相关指南，其推荐级别均为B 级，在AGREE Ⅱ 6 个领域的平均得分率分别为87.10%、63.10%、62.50%、87.69%、53.13% 和47.32%。组内相关系数为0.84（P <0.001），评价者间总的一致性非常好。结论：现有急性心力衰竭临床指南总体质量较高，但在制定的方法学上仍有待进一步的规范，尤其是应用性和独立性领域。此外，国外指南在使用过程中需要考虑其是否适应我国的临床环境。

Abstract: Objective: To evaluate the quality of clinical practice guidelines for acute heart failure in order to provide reference and consultation for clinical practice. Methods: We searched the databases of PubMed, EMbase, SinoMed,CNKI, WanFang and the online resources such as SIGN, NICE, NGC, RNAO et al. to gather clinical practice guidelines nationally and internationally for acute heart failure. We reviewed and examined the chosen guidelines by AGREE II instrument and meanwhile assessed the overall agreement among reviewers via the intragroup correlation coefficient (ICC).Results: A total of seven evidence-based guidelines for acute heart failure were finally included holding recommendation level B and the mean scores of six domains by AGREE II were 87.10%, 63.10%, 62.50%, 87.69%, 53.13% and 47.32% respectively.Intragroup observer agreement was significantly good and the overall intragroup correlation coefficient was 0.84 ( P<0.001).Conclusion: The clinical practice guidelines for acute heart failure are of good quality in general. However, we suggest that the methodology of those guidelines, especially in terms of applicability and independence, should be better normalized. The recommendations for acute heart failure should be suitable to local clinical/medical environments (e.g. China).

张方圆康晓凤韦丙奇吴海彤李峥. 基于AGREE Ⅱ评价急性心力衰竭临床实践指南的质量[J]. , 2016, 16(1): 50-54.