Chinese General Practice

Special Issue: 指南/共识最新文章合辑

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Development Status of Applicability Evaluation Tools for Clinical Practice Guidelines in China

  

  1. 1. The First Clinical Medical College,Henan University of Chinese Medicine,ZhengZhou 450000,China;2. Respiratory Department,The First Affiliated Hospital of Henan University of CM,ZhengZhou 450000,China
  • Received:2024-04-24 Revised:2024-06-16 Accepted:2024-06-27
  • Contact: YU Xueqing,Professor/Doctoral supervisor;E-mail:yxqshi@163.com

国内临床实践指南适用性评价工具的研制现状与思考

  

  1. 1.450000 河南省郑州市,河南中医药大学第一临床医学院;2.450000 河南省郑州市,河南中医药大学第一附属医院呼吸科
  • 通讯作者: 余学庆,主任医师/博士生导师;E-mail:yxqshi@163.com
  • 基金资助:
    国家自然科学基金资助项目(82174307);河南省中医学“双一流”创建科学研究专项(HSRP-DFCTCM-2023-8-18);河南省中医药科研专项(2022JDZX118)

Abstract: Background With the rapid growth of the number of clinical practice guidelines in China,existing applicability evaluation tools are showing a rapid development trend,and there are generally problems such as the lack of evaluation dimensions and a single target user,which are difficult to suit the urgent needs of guideline applicability evaluation under the coexistence of traditional Chinese and Western medicine medical systems. Objective To systematically evaluate the applicability evaluation tools of clinical practice guidelines formulated in China and provide references for the correct selection and application of the applicability evaluation tools of guidelines. Methods Systematically searched CNKI,WANFANG,VIP,Pubmed,Embase,Web of Science,STAR platform,Medlive,collected domestic guideline applicability evaluation tools according to established standards,classified and compared the applicability evaluation tools. Results 5 complete guideline applicability evaluation tools and 3 guideline quality evaluation tools containing applicability evaluation items were included. The target users of the seven tools are all physicians. The appraisal areas of the eight guideline applicability evaluation tools mainly include:basic information,readability,feasibility,acceptability,overall evaluation,and recommendations. The three Chinese medicine evaluation tools reflect the diagnosis and treatment characteristics of traditional Chinese medicine in terms of item settings,but lack of item settings in the fields of availability and acceptability. Universality evaluation tools lack entry settings for personal suggestions. Conclusion At present,although there are a large number of applicability evaluation tools for clinical practice guidelines.there are still problems such as a single user group,different evaluation fields,and long update cycles. Users should fully consider the evaluation purpose and field,and select the appropriate applicability evaluation tool of the guideline;the future applicability evaluation tool revision can expand the target user group to patients and guideline developer groups. Therefore,it can ensure the progressiveness and effectiveness of the applicability evaluation tools.

Key words: Guidelines, Clinical practicum, Assessment instruments, Systematic reviews, Applicability, Progress reports

摘要: 背景 随着我国临床实践指南数量的快速增长,现有适用性评价工具呈现快速发展态势,但目前仍存在评价维度缺失、目标使用人群单一等问题,难以满足中西医并存医疗体系下指南适用性评价的迫切需求。目的 系统评价国内制定的临床实践指南适用性评价工具,为正确选择和应用指南适用性评价工具提供参考。方法 系统检索中国知网、万方数据知识服务平台、维普网、中华医学期刊全文数据库、PubMed、Embase、Web of Science 等中英文数据库,以及临床实践指南科学性、透明性和适用性评级工具平台和医脉通指南频道,收集其中适用于评价国内指南的工具,检索时限为建库至 2024-04-01。由 2 名研究者将收集到的资料按照相应的纳排标准进行提取及筛选,并把纳入的适用性评价工具进行分类归纳和对比分析。结果 最终纳入 5 个完整的指南适用性评价工具和 3 个包含适用性评价条目的指南质量评价工具。8 个指南适用性评价工具的目标使用者均为医师,评价领域主要包括基本信息、可读性、可行性、可接受性、总体评价、建议等;3 个中医类指南适用性评价工具在条目设置上体现了中医的诊疗特点,但是在可获得性、可接受性领域缺少条目设置。普适性指南评价工具在个人建议方面缺少条目设置。结论 目前国内研制的指南适用性评价工具虽然数量众多,但仍存在使用人群单一,评价领域不同,更新周期较长等问题。使用者应充分考虑评价目的和领域,选择合适的指南适用性评价工具。今后适用性评价工具修订时可将目标使用者群体扩展到患者和指南研发者群体,并制定更新计划,从而保证评价工具的先进性和有效性。

关键词: 指南, 临床实践, 评估工具, 系统评价, 适用性, 进展报告

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