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目的系统评价儿童卡氏肺囊虫病循证指南的质量,比较药物治疗方案异同,为临床应用提供参考。方法计算机检索TRIP、Pub Med、CNKI、VIP、Wan Fang Data、CBM及美国国家指南文库(U.S National Guideline Clearinghouse,NGC)和国际指南联盟(Guidelines International Network,GIN),纳入儿童卡氏肺囊虫病的循证指南,而后使用AGREEⅡ工具评价纳入指南的方法学质量,分析比较各指南推荐的异同。结果共纳入3个循证指南,包括美国2个,国际学术组织1个。其中1个指南针对儿童,另2个适用于不同年龄段儿童和成人。AGREEⅡ评分结果显示,在六大领域的评分中,各指南的范围和目的、参与人员、制定的严谨性、清晰性和编辑的独立性得分均>60%,但适用性得分仅分别为46%、25%和31%。此外,各指南证据分级推荐系统不一致,药物治疗推荐意见存在差异。结论现有儿童卡氏肺囊虫病循证指南整体质量不高,证据质量和推荐强度标准尚需统一,目标人群和推荐意见存在一定差异。
Objective To systematically evaluate the quality of evidence-based guidelines for Pneumocystis carinii disease in children and to compare the similarities and differences between the drug treatment programs and provide a reference for clinical application. Methods We searched TRIP, Pub Med, CNKI, VIP, Wan Fang Data, CBM and the US National Guideline Clearinghouse (NGC) and the International Guidelines Association (GIN) Of the evidence-based guidelines, and then use AGREE Ⅱ tools to evaluate the quality of the methodology included in the guide, analysis and comparison of the similarities and differences between the guidelines recommended. Results A total of 3 evidence-based guides were included, including 2 in the United States and 1 in international academic organizations. One of the guidelines is for children and the other two are for children of different ages and adults. The results of AGREEⅡscore showed that the scope and purpose of each guideline, the participants, the strictness, clarity and editorial independence of each guideline were all higher than 60% in the scores of the six fields, but the applicability scores were only 46% , 25% and 31%. In addition, the guidelines for evidence-based recommendation system inconsistent, drug treatment recommendations vary. Conclusion The overall quality of evidence-based guidelines for cardiopulmonary cysticercosis in children is poor. The standards of evidence quality and recommended strength still need to be unified. There is a certain difference between target groups and recommended opinions.