我国结直肠癌筛查循证指南关键问题清单的构建

目的 对现有结直肠癌筛查循证指南进行梳理，搭建和确立适用于我国结直肠癌筛查循证指南的关键问题清单，为我国结直肠癌筛查循证指南的制订提供理论基础和参考。方法 首先，根据WHO指南制订流程定义循证指南，对符合该定义的指南进行全面解读；其次，结合循证指南的制订流程，形成初步的结直肠癌筛查循证指南关键问题问卷；最后，邀请临床、循证医学及流行病学等多领域专家，通过Delphi法形成适用于我国的结直肠癌筛查循证指南关键问题清单。结果 Delphi专家论证共收回有效问卷34份，专家权威系数为0.81，权威程度较高；问卷各条目专家意见集中程度较高，满分比均 > 75%，变异系数 < 0.3。经论证形成的结直肠癌筛查循证指南关键问题清单分为流行病学问题、人群风险分类、筛查起止年龄、筛查方法、实施相关情况、专家组成员选择6个维度共计20个详细条目，基本涵盖了适用于我国结直肠癌筛查循证指南制订过程中需要考虑的问题。结论 本研究所形成的结直肠癌筛查循证指南关键问题清单可指导未来我国结直肠癌筛查循证指南的制订工作，同时，该框架也可为其他癌症筛查循证指南的制订提供参考。

Construction of key question list in the evidence-based guidelines for colorectal cancer screening in China

Objective To establish the key question list for the development of evidence-based guideline in China according to the content and limitation of current evidence-based guidelines around the world. Methods First, we introduced the evidence-based guidelines in detail which met the criteria based on World Health Organization guideline development handbook and then formulated the draft list of key questions for the development of evidence-based guidelines. At last, the Delphi method was used to determine the list of key questions in developing evidence-based guidelines of colorectal cancer screening. Results Totally, 34 questionnaires were collected, with experts from clinical and epidemiological fields. The average experts'' authority coefficient was 0.81, indicating a high degree of authority. The concentration of opinions on all items in the questionnaire was relatively high, with the full score ratio greater than 75% and the coefficient of variation less than 0.3. The list of key questions on evidence-based guidelines for colorectal cancer screening has been divided into six parts:epidemiological problems, risk classification, screening age, screening tools, implementation and selection of steering group members, which covers the issues that need to be considered in the development of evidence-based colorectal cancer screening guidelines in China. Conclusion The key question list for evidence-based guideline development in our study can be applied to the development of evidence-based guidelines for colorectal cancer screening in the future, as well as the development of evidence-based guidelines for other cancer screening in China.