A review of the quality of primary caregiver-implemented communication intervention research for children with ASD

BackgroundMost children with autism spectrum disorder (ASD) spend most of their waking hours at home with their caregivers; thus, involving caregivers in interventions may increase communication interaction opportunities across time and settings.MethodIn this review, an analysis of the quality of the research on communication interventions implemented or mediated by caregivers of children with ASD was conducted based on the What Works Clearinghouse guidelines (Kratochwill et al., 2010) and adapted by Maggin et al. (2013).ResultsAbout one-third of studies included in this review were found to meet the design standards, indicating that those studies utilized a high quality of research design. The studies that failed to meet the design standards were primarily those that lacked sufficient interobserver agreement data collected in each condition, thus, not meeting the minimum quality thresholds. To evaluate an overall effectiveness, a total of 31 single-case experiments were evaluated with the evidence standards. As a result, about half of the experiments were found to have either strong or moderate evidence of an effect.ConclusionsThe findings in this review suggest issues that need to be addressed in the field related to quality of designs in single-case research on primary caregiver-implemented communication interventions for children with ASD. Limitations and implications for future research and for practitioners are discussed.     

中国儿童与老年健康证据转化平台的构建与应用

目的介绍并推广中国儿童与老年健康证据转化平台(Chinese Clearinghouse for Evidence Translation in Child & Aging Health,CCET)。方法分别成立儿童、老年健康顾问委员会,利用科学的评价量表评价筛选国内外相关的儿童、老年健康促进项目并由研究团队翻译转化。与兰州博阳软件工程有限公司合作,根据网站需呈现的内容与目标功能,共同规划设计网站框架与界面,初步建立站点。将转化的健康证据及其他信息资源（疾病基本情况、项目评价量表、研究报告标准等）上传使之在网站相应栏目中呈现,建立CCET网站,并通过微信和微博媒介定期传播儿童及老年健康最新进展、循证研究最新方法。结果CCET主要由儿童健康、老年健康、评价量表、报告标准、推广应用和老年抑郁症循证防治数据库6个版块组成。CCET儿童与老年健康促进项目由国内外专家采用科学的评价量表筛选和评价,转化的证据科学性强,目前已有相关研究机构和社区有意向参与CCET研究和应用转化项目。结论CCET致力于循证方法培训,建立国内健康干预项目的科学性和适用性评价系统,对国外证据转换后的后续干预项目培训,提升服务机构能力,以及综合干预课程研发。CCET信息全面、界面简单、用户友好,为促进我国儿童与老年健康提供证据支持。     

Recommendations for Acupuncture in Clinical Practice Guidelines of the National Guideline Clearinghouse

Objective: To organize the clinical practice guidelines(CPGs) related to acupuncture included in the National Guideline Clearinghouse(NGC) to systematically summarize the diseases and disorders most commonly treated with acupuncture, the strength of recommendations for acupuncture and the quality of evidence. Methods: The NGC database was systematically searched for guidelines that included acupuncture as an intervention. Two independent reviewers studied the summaries and the full texts of the guidelines and included guidelines based on the inclusion and exclusion criteria. Thirty-nine guidelines were collected with 80 recommendations. The Appraisal of Guidelines for Research and Evaluation(AGREE) Ⅱ instrument was used to assess the quality of these guidelines. Results: Of the 80 recommendations on acupuncture, 49 recommendations were clearly for acupuncture, 25 recommendations were against acupuncture and 6 recommendations did not indicate any clear recommendations, 37 recommendations were for painful diseases/disorders, and 12 recommendations were for non-painful diseases/disorders. Locomotor system disorders were the most common in the painful diseases/disorders category. Out of all the recommendations for acupuncture, most recommendations(87.76%) were weak in strength, and most of the evidence(40.84%) was of low quality. Conclusion: In the National Guideline Clearinghouse, the recommendations for acupuncture focus on painful diseases/disorders. The recommendations in the guidelines are not high in strength, and most of the evidence is moderate or low in quality.     

The Yale Guideline Recommendation Corpus: A representative sample of the knowledge content of guidelines

Objective

To develop and characterize a large, representative sample of guideline recommendations that can be used to better understand how current recommendations are written and to test the adequacy of guideline models. We refer to this sample as the Yale Guideline Recommendation Corpus (YGRC).

Method

To develop the YGRC, we extracted recommendations from guidelines downloaded from the National Guideline Clearinghouse (NGC). We evaluated the representativeness of the YGRC by comparing the frequency of use of controlled vocabulary terms in the YGRC sample and in the NGC. We examined semantic and formatting indicators that were used to denote recommendation statements.

Results

In the course of reviewing 7527 recommendation statements, we extracted 1275 recommendations from the NGC and characterized the guidelines from which they were derived. Both semantic and formatting indicators were used inconsistently to denote recommendations. Recommendation statements were not reliably identifiable in 31.6% (310/982) of the guidelines and many recommendations were not executable as written. We also found variability and inconsistency in the way strength of recommendation is currently reported. Over half of the recommendations (52.7%), did not indicate strength, while 6.5% inaccurately indicated strength.

Conclusion

The YGRC provides a representative sample of current guideline recommendations and demonstrates considerable variability and inconsistency in the way recommendations are written and in the way the recommendation strength is currently reported.     

美国国立临床诊疗指南数据库介绍

美国国立临床诊疗指南数据库是目前全球具有影响力的临床实践指南数据库之一。本文通过对其数据库内容、服务方式以及功能特点等信息的介绍和分析，希望为国内广大医药专业人员了解和获取国际最新、最有效的临床实践指南提供参考。