基于AGREE 的中医循证

目的:采用AGREE工具评价国内第一批中医循证临床实践指南的质量。方法:采用手工检索的方法,检索2007年～2011年间,由WHO西太区资助、中国中医科学院组织编写的中医循证临床实践指南,纳入采用AGREE工具进行评价的指南。分别分析每个指南的范围与目的、参与人员、制定的严谨性、清晰性与可读性、应用性、编辑独立性,最后进行全面评估。结果:共检索到28个指南,其中26个指南符合纳入标准。研究结果表明,中医循证临床实践指南的编辑独立性质量最高,平均得分81.46%;其次为制定的严谨性,平均得分80.95%;范围与目的平均得分79.96%;清晰性与可读性平均得分70.88%;参与人员平均得分61.28%;应用性质量最低,平均得分27.09%。全面评估显示,强烈推荐使用的指南有9个,推荐(补充或改进)的指南有5个,11个指南不能确定是否推荐使用。结论:中医循证临床实践指南的应用性质量很低,在以后的指南研制中,要注重该方面质量的提高。

Study on Quality Assessment of TCM Clinical Practice Guidelines Based on AGREE Instrument

This study is aimed to identify and assess the quality of first batch of evidence-based clinical practice guidelines (CPGs) in traditional Chinese medicine (TCM) using appraisal of guidelines research and evaluation (AGREE) instrument. The evidence-based CPGs in TCM are supported by WHO/WPR, whose development was organized by the China Academy of Chinese Medical Sciences. Data were identified by manual retrieval. The CPGs assessed by AGREE instrument were included. Data in each CPG were analyzed in terms of six domains in the AGREE instrument including scope and purpose, participants, conscientiousness, clarity, readability, applicability and editorial independence of CPGs. There are 28 CPGs identified. Among them, 26 CPGs were included. The results showed that the majority of CPGs presented with high quality editorial independence. And the average score was 81.46%. The conscientiousness of CPGsdevelopment was also good. The average score was 80.95%. The scope and purpose scored 79.96%. The clarity and readability scored 70.88%. The participants scored 61.28%. But the applicability scored the lowest with only 27.09%. The general evaluation revealed that nine CPGs were rated as "strongly recommended," five as "recommended with provision or alternation," and eleven as "unsure." It is concluded that the quality of applicability is a significant shortcoming. Special attention should be paid to improve the quality of applicability in the development of TCM CPGs.