| 田剑波,温艳,杨卓煜,郑亚迪,吴峥,李江,李霓,赫捷.全球结直肠癌筛查指南及共识质量评价[J].中华流行病学杂志,2021,42(2):248-257 |
| 全球结直肠癌筛查指南及共识质量评价 |
| Quality assessment of global colorectal cancer screening guidelines and consensus |
| 收稿日期:2020-09-02 出版日期:2021-02-24 |
| DOI：10.3760/cma.j.cn112338-20200902-01119 |
| 中文关键词: 结直肠肿瘤 筛查 指南 共识 质量评价 |
| 英文关键词: Colorectal neoplasms Screening Guidelines Consensus Quality assessment |
| 基金项目:国家重点研发计划（2018YFC1315000，2016YFC1302702）；中国医学科学院医学与健康科技创新工程项目（2019-I2M-2-002）；中国医学科学院中央级公益性科研院所基本科研业务费（2019PT320027）；北京市优秀人才培养资助-青年拔尖团队项目（2017000021223TD05） |
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| 中文摘要: |
| 目的 系统评价结直肠癌筛查指南/共识的方法学和报告质量，为我国结直肠癌筛查工作的开展以及指南/共识的制定提供参考依据。方法 系统检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、PubMed、Embase、Web of Science、Cochrane Library和Guidelines International Network，并同时检索美国预防服务工作组、美国癌症学会等刊登的筛查指南/共识作为补充，选择2020年9月1日前发表的所有中、英文结直肠筛查指南/共识。采用开发指南/共识研究和评估工具Ⅱ（AGREE Ⅱ）和国际实践指南报告标准（RIGHT）对结直肠癌筛查指南/共识进行质量评估。结果 经过质控后共纳入19部指南/共识，主要由美国、中国、澳大利亚、加拿大、英国、韩国以及国际组织发布，其中美国发布的指南/共识最多（7部）；AGREE Ⅱ评价结果显示，19部指南/共识整体质量较高，各指南/共识得分均值在范围和目的、清晰性领域得分较高，分别为87.5%和89.6%，但在参与人员（47.0%）、严谨性（42.3%）、应用性（47.5%）和独立性（50.2%）领域表现不佳。其中，整体得分≥ 50.0%的有12部，推荐等级达到A级的有13部、B级的有2部、C级的有4部；RIGHT评价结果显示，各领域平均报告率分别为基本信息（76.3%）、背景（77.0%）、证据（55.8%）、推荐意见（59.4%）、评审和质量保证（26.3%）、资金资助和利益冲突（43.4%）、其他方面（49.1%）。亚组分析显示，中国6部指南/共识质量与发达国家还有一定的差距。结论 结直肠癌筛查指南/共识发布数量呈上升趋势且整体质量较高，但在报告规范性方面有待提高。 |
| 英文摘要: |
| Objective To systematically evaluate the methodology and reporting quality of colorectal cancer (CRC) screening guidelines/consensus and provide lights for drafting CRC screening guidelines in China.Methods The literature retrieval for all the Chinese and English guidelines published before September 1st, 2020 was conducted by using Chinese/English databases, such as China National Knowledge Infrastructure, Wanfang Data, VIP, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, Guideline International Network, and supplement with the official website of multiple regions, such as the U.S. Preventive Services Task Force and American Cancer Society. We utilized The Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) approaches to assess the quality of CRC screening guidelines/consensus comprehensively.Results After quality control, a total of 19 guidelines/consensus released by the United States, China, Australia, Canada, Britain, South Korea, and International organizations are successfully included, and strikingly, most of those belong to the United State(7). The results of the AGREE Ⅱ quality evaluation show that the average scores of scope and purpose (87.5%) and clarity of presentation (89.6%) are high. In contrast, there are deficient in stakeholder involvement (47.0%), the rigor of development (42.3%), applicability (47.5%), and editorial independence (50.2%). Among all the guidelines, there are 12 with an overall score of 50 or more, 13 with a recommendation level of "A", 2 with a rating of "B" and 4 with a rating of "C". Additionally, the RIGHT evaluation revealed that the average report rate in each field is necessary information (76.3%), background (77.0%), evidence (55.8%), recommendations (59.4%), review and quality assurance (26.3%), funding and declaration and management of interests (43.4%), other information (49.1%). Among all the guidelines, six have good reporting quality, whereas the additional 13 have general or weak evidence. Furthermore, subgroup analysis indicates that the quality of guidelines in developed countries is superior to that of China.Conclusion The number of CRC screening guidelines/consensus is increasing gradually, and the overall quality of those is high, but the normative nature is warranted to be strengthened. |
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