《肺痈中医内科临床诊疗指南(2017年修订评价稿)》的AGREE评价
|
摘要
目的:采用AGREEⅡ工具对《肺痈中医内科临床诊疗指南(2017年修订评价稿)》进行指南方法学的质量评价,为进一步完善《肺痈中医内科临床诊疗指南》提供参考,修订出较为科学规范的《肺痈中医内科临床诊疗指南》。方法:由包括中医内科、文献学、标准化等领域的4位专家,使用AGREEⅡ评估工具对指南进行质量评价,并通过组内相关系数(ICC)对评价者间总的一致性进行评价。结果:《肺痈指南》的AGREEⅡ评价在范围和目的、参与人员、严谨性、清晰性、应用性和独立性6个领域的平均得分率分别为88.89%、70.83%、75.00%、90.28%、67.71%和77.08%,推荐级别为A级。在范围和目的、严谨性2个领域的的ICC均大于0.8,评价者间一致性非常好;清晰性、应用性2个领域的ICC在0.61～0.80之间,评价者间一致性好;独立性领域的ICC在0.41～0.60之间,评价者间一致性中等;参与人员ICC值为0,评价者间一致性非常差。4名专家中2名表示"愿意推荐使用",2名表示"推荐修订后使用"。结论:《肺痈中医内科临床诊疗指南(2017年修订评价稿)》总体质量较高,但在制定的方法学上仍有待进一步的规范,尤其是独立性和参与人员领域。
Objective: To evaluate the quality of manuscript of clinic guide of traditional Chinese medicine(TCM) for lung carbuncle by using the Appraisal of Guidelines for Research and Evaluation I(AGREE I) instrument, and to provide referencesto improve the manuscript of the clinic guide. Methods: AGREE I evaluation tool was used to evaluate the quality of the guidelines by four experts including internal medicine of TCM, documentation, standardization and other fields, and the overall consistency among the evaluators was evaluated by the intra-group correlation coefficient(ICC). Results: AGREE I scored 88.89%, 70.83%, 75.00%, 90.28%, 67.71% and 77.08% in the scope and purpose, participants, rigor, clarity, applicability, and independence of the guidelines, respectively. The recommended grade was A. ICC in the 2 areas of scope and purpose, rigor was greater than 0.8, and the consistency among the evaluators was very good; ICC in the 2 areas of clarity, applicability was 0.61 to 0.80, and the consistency among the evaluators was good; the ICC in the independent field was between 0.41 and 0.60; the ICC value of the participants was 0, and the consistency among the evaluators was very poor. Two of the 4 experts said 'willing to recommend this guide' and 2 said 'recommended to use this guide after revision'. Conclusion: The manuscript of clinic guide of TCM for lung carbuncle was of good quality in general. However, we suggested that the methodology of the guidelines, especially in terms ofapplicability and independence, should be better normalized.
Objective: To evaluate the quality of manuscript of clinic guide of traditional Chinese medicine(TCM) for lung carbuncle by using the Appraisal of Guidelines for Research and Evaluation I(AGREE I) instrument, and to provide referencesto improve the manuscript of the clinic guide. Methods: AGREE I evaluation tool was used to evaluate the quality of the guidelines by four experts including internal medicine of TCM, documentation, standardization and other fields, and the overall consistency among the evaluators was evaluated by the intra-group correlation coefficient(ICC). Results: AGREE I scored 88.89%, 70.83%, 75.00%, 90.28%, 67.71% and 77.08% in the scope and purpose, participants, rigor, clarity, applicability, and independence of the guidelines, respectively. The recommended grade was A. ICC in the 2 areas of scope and purpose, rigor was greater than 0.8, and the consistency among the evaluators was very good; ICC in the 2 areas of clarity, applicability was 0.61 to 0.80, and the consistency among the evaluators was good; the ICC in the independent field was between 0.41 and 0.60; the ICC value of the participants was 0, and the consistency among the evaluators was very poor. Two of the 4 experts said 'willing to recommend this guide' and 2 said 'recommended to use this guide after revision'. Conclusion: The manuscript of clinic guide of TCM for lung carbuncle was of good quality in general. However, we suggested that the methodology of the guidelines, especially in terms ofapplicability and independence, should be better normalized.
引文
[1]黄帝内经素问.傅景华,陈心智,点校.北京:中医古籍出版社,1997:76
[2]清·喻昌.医门法律.北京:中国中医药出版社,2002:345
[3]汉·张仲景.金匮要略.北京:学苑出版社,2014:31
[4]唐·孙思邈.备急千金要方.北京:中国医药科技出版社,2011:304
[5]明·陈实功.外科正宗.北京:中国中医药出版社,2002:124
[6]中华中医药学会.中医内科常见病诊疗指南中医病证部分:ZYYXH/T 9-2008.北京:2008
[7]中华中医药学会.中华人民共和国中医药行业标准·中医临床诊疗指南编制通则:ZYYXH/T473-2015.北京,2015
[8]The AGREE Collaboration.Appraisal of guidelines for research and evaluation instrument.http://www.agreetrust.org/(Update:September 2013)
[9]CHEN Y,HU S L,LI Y P.Guidelines concerning pharmacological intervention in simple hypertension:A systematic review.Chin J Evid-based Med,2012,12(10):1180-1194
[10]张方圆,康晓凤,韦丙奇,等.基于AGREEⅡ评价急性心力衰竭临床实践指南的质量.中国护理管理,2016,16(1):51-53
[11]SHROUT P E,FLEISS J L.Intracluss correlations:uses in assessing rater reliability.Psychol Bull,1979(86):420-428
[12]RIOS E,SERON P,LANAS F.Evaluation of the quality of clinical practice guidelines for the management of esophageal or gastricvariceal bleeding.European Journal of Gastroenterology&Hepatology, 2014,4(26):422-431
[2]清·喻昌.医门法律.北京:中国中医药出版社,2002:345
[3]汉·张仲景.金匮要略.北京:学苑出版社,2014:31
[4]唐·孙思邈.备急千金要方.北京:中国医药科技出版社,2011:304
[5]明·陈实功.外科正宗.北京:中国中医药出版社,2002:124
[6]中华中医药学会.中医内科常见病诊疗指南中医病证部分:ZYYXH/T 9-2008.北京:2008
[7]中华中医药学会.中华人民共和国中医药行业标准·中医临床诊疗指南编制通则:ZYYXH/T473-2015.北京,2015
[8]The AGREE Collaboration.Appraisal of guidelines for research and evaluation instrument.http://www.agreetrust.org/(Update:September 2013)
[9]CHEN Y,HU S L,LI Y P.Guidelines concerning pharmacological intervention in simple hypertension:A systematic review.Chin J Evid-based Med,2012,12(10):1180-1194
[10]张方圆,康晓凤,韦丙奇,等.基于AGREEⅡ评价急性心力衰竭临床实践指南的质量.中国护理管理,2016,16(1):51-53
[11]SHROUT P E,FLEISS J L.Intracluss correlations:uses in assessing rater reliability.Psychol Bull,1979(86):420-428
[12]RIOS E,SERON P,LANAS F.Evaluation of the quality of clinical practice guidelines for the management of esophageal or gastricvariceal bleeding.European Journal of Gastroenterology&Hepatology, 2014,4(26):422-431