胃癌筛查领域指南方法学质量和报告质量的系统评价

目的系统评价国内外现有胃癌筛查指南的方法学质量,为今后同类指南的制定和更新提供标准和参考依据。方法以“指南”“共识”“规范”“标准”“胃癌”“胃部肿瘤”“筛查”“筛检”“诊断”“Gastric Cancer”“Gastric Tumor”“guideline”“recommendation”“Early Detection of Cancer”“Screening”为检索关键词,系统检索中国知网、万方知识服务平台、中国生物医学文献数据库、中国临床指南文库、PubMed、The Cochrane Library、EMBASE、Web of Knowledge等数据库截止到2018年9月的中、英文文献,并同时检索美国预防服务工作组、美国癌症学会、国际癌症研究机构、澳大利亚癌症委员会、国际指南协作网的机构官网刊登的指南作为补充。纳入标准为胃癌筛查的独立指南文件,且符合美国医学研究所对指南的定义;排除标准包括指南的摘要、解读及评价类文献、重复发表、已更新的原始版指南以及胃癌临床治疗或实践指南。采用欧洲指南研究与评估工具(AGREEⅡ)和实践指南报告标准(RIGHT)对胃癌筛查指南的质量和报告规范程度进行比较和评价。结果共纳入5篇指南。AGREEⅡ质量评价结果显示,5篇指南整体质量参差不齐,其中推荐等级为“A”的有1篇,等级为“B”的有1篇,等级为“C”的有3篇;各指南在范围和目的、清晰性领域得分较高,在严谨性、独立性领域得分差异较大,在参与人员、应用性领域得分普遍较低。RIGHT评价结果显示,5篇指南报告质量有待提高,报告质量较差的6个条目分别为背景、证据、推荐意见、评审和质量保证、资金资助与利益冲突声明和管理以及其他方面。结论纳入的胃癌筛查指南的质量整体一般,规范性有待加强。

Systematic review of methodological quality and reporting quality in gastric cancer screening guidelines

Objective To systematically evaluate the quality of gastric cancer screening guidelines/recommendations,and provide a reference for the update of gastric cancer screening guidelines/recommendations in China.Methods"guidelines/consensus/specifications/standards","stomach/gastric tumors","screening/diagnosis","guideline/recommendation","gastric cancer/gastric tumor,""early detection of cancer/screening"were searched as keywords in PubMed,Embase,Web of knowledge,China Knowledge Network,Wanfang,China Biomedical Literature Database,and Cochrane Library,as well as the US Preventive Services Working Group,the American Cancer Society,the International Agency for Research on Cancer,the Australia Cancer Council and the International Guide Collaboration Network at the end of July 2018.The inclusion criteria were independent guidelines/recommendation documents for gastric cancer screening.The exclusion criteria were guideline abstracts,interpretation and evaluation literature,duplicate publications,updated original guidelines,and clinical treatment or practice guidelines for gastric cancer.The language was limited to Chinese and English.The European Guide to Research and Evaluation Tools(AGREEⅡ)and Practice Guideline Reporting Standard(RIGHT)for Gastric Cancer Screening Guidelines/Recommendations were used to compare and evaluate the quality and reporting standard of gastric cancer screening guidelines/recommendations.Results A total of five guides/recommendations were included.The results of the AGREEⅡquality evaluation showed that the overall quality of five guides/recommendations was different,including one recommended for"A",one for"B",and three for"C".Each guide/recommendation scored higher in the scope and purpose,clarity,and scores were more significant in the areas of rigor and independence.In the participants,the application field scores were generally low.The RIGHT evaluation results showed that the quality of five guides/recommendations should be improved.The six items with poor report quality were background,evidence,recommendations,review and quality assurance,funding and conflict of interest statement and management,and other aspects.Conclusion The quality of the included gastric cancer screening guidelines/recommendations is generally low,and the standardization should be strengthened.