Abstract
李江,杨珂璐,蔡依彤,田金徽,郑亚迪,温艳,杨卓煜,李霓,陈万青,赫捷.全球乳腺癌筛查指南质量评价[J].Chinese journal of Epidemiology,2021,42(2):219-226
全球乳腺癌筛查指南质量评价
Quality assessment of global breast cancer screening guidelines
Received:August 06, 2020  
DOI:10.3760/cma.j.cn112338-20200806-01032
KeyWord: 乳腺肿瘤  筛查  指南  共识  质量评价
English Key Word: Breast neoplasms  Screening  Guidelines  Consensus  Quality assessment
FundProject:北京市优秀人才培养资助-青年拔尖团队项目(2017000021223TD05)
Author NameAffiliationE-mail
Li Jiang Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Yang Kelu Evidence-based Medicine Center, Lanzhou University, Lanzhou 730000, China  
Cai Yitong Evidence-based Medicine Center, Lanzhou University, Lanzhou 730000, China  
Tian Jinhui Evidence-based Medicine Center, Lanzhou University, Lanzhou 730000, China  
Zheng Yadi Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Wen Yan Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Yang Zhuoyu Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Li Ni Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China nil@cicams.ac.cn 
Chen Wanqing Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
He Jie Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
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Abstract:
      目的 对已发表的乳腺癌筛查指南进行质量评价,为我国乳腺癌筛查指南的制订提供借鉴和参考。方法 检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、中国生物医学文献服务系统、维普网和万方数据知识服务平台中乳腺癌筛查指南,检索时间为建库至2020年8月。由2名研究人员独立筛选文献和提取资料,采用开发指南研究和评估工具Ⅱ(AGREEⅡ)和国际实践指南报告标准(RIGHT)对纳入的指南进行质量评价。结果 共纳入15部乳腺癌筛查指南,其中7部由美国发布,发表年份主要集中在2015-2019年,11部指南有更新版本。AGREEⅡ评价结果显示,严谨性(47.0%±22.1%)和应用性(44.0%±15.1%)得分较低,RIGHT评价结果显示,评审和质量保证(46.7%±39.9%)及资金资助和利益冲突(41.7%±24.4%)报告较差。根据AGREEⅡ整体得分推荐使用的指南共有6部,修改后推荐使用的指南有9部;RIGHT报告水平良好的指南有4部,报告水平一般的指南共11部。综合质量最好的是美国国立综合癌症网络2018年发布的指南(AGREEⅡ:83.3%,RIGHT:80.0%)和美国癌症学会2015年发布的指南(AGREEⅡ:83.3%,RIGHT:85.7%)。结论 乳腺癌筛查指南的质量以中等质量为主,应加强对指南的制订过程和质量控制等内容的关注。
English Abstract:
      Objective To evaluate the quality of the published breast cancer screening guidelines to provide a reference for domestic studies in the future.Methods PubMed, Embase, Cochrane Library, Web of Science, SinoMed, China National Knowledge Infrastructure, VIP, and Wanfang Data were searched to identify breast cancer screening guidelines on until August 2020. Two reviewers screened literature and extracted data independently. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREEⅡ) and Reporting Items for Practice Guidelines in Healthcare(RIGHT) tools were used to evaluate the quality of the included guidelines.Results A total of 15 breast cancer screening guidelines were included, of which seven were published in the United States, with publication years focusing on 2015 to 2019, and 11 guidelines had updated versions. "Rigour of development" (47.0%±22.1%) and "Applicability" (44.0%±15.1%) of AGREEⅡ scored lower than other domains. "Review and quality assurance" (46.7%±39.9%) and "Funding, declaration, and management of interests" (41.7%±24.4%) of RIGHT were reported poorer than others. There were six guidelines recommended and another nine recommended with modifications based on the overall AGREEⅡ score. There were four guidelines with a good level, and another 11 were with a moderate level of RIGHT. The National Comprehensive Cancer Network published the best overall quality guidelines in 2018 (AGREEⅡ:83.3%, RIGHT:80.0%) and by the American Cancer Society in 2015 (AGREEⅡ:83.3%, RIGHT:85.7%).Conclusion The quality of breast cancer screening guidelines was predominantly of moderate quality, and greater attention should be paid to the guideline development process and quality control of the guidelines.
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