全球乳腺癌筛查指南质量评价

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。

Quality assessment of global breast cancer screening guidelines

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&EvaluationⅡ(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 AGREEⅡscored 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 AGREEⅡscore.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.