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ENGLISH ABSTRACT
2018年肺血栓栓塞症诊治与预防指南的质量评价
万铠瑞
赖宁
马杰羚
李瑶
吴君万
黄万晓
江梅
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1001-0939.2019.03.012
Quality assessment of the clinical practice guideline for diagnosis, treatment and prevention of pulmonary thromboembolism, 2018
Wan Kairui
Lai Ning
Ma Jieling
Li Yao
Wu Junwan
Huang Wanxiao
Jiang Mei
Authors Info & Affiliations
Wan Kairui
Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Lai Ning
Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, Department of Respiratory Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
Ma Jieling
Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Li Yao
Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Wu Junwan
Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Huang Wanxiao
Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Jiang Mei
Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, Department of Respiratory Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
·
DOI： 10.3760/cma.j.issn.1001-0939.2019.03.012
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摘要

目的评价国内2018年发布的"肺血栓栓塞症诊治与预防指南"的质量，为今后更新和制定我国临床实践指南提供借鉴和参考。

方法利用国际公认的指南质量评价工具AGREE Ⅱ（appraisal of guidelines for research and evaluation Ⅱ）对我国2018年发布的"肺血栓栓塞症诊治与预防指南"进行质量评价。AGREE Ⅱ总共包含6个领域共23个条目和2个总体评估条目，每个条目得分为1~7分，综合考虑所有领域和条目来评估指南的质量。

结果该指南AGREE Ⅱ六个领域中"范围和目的"得分76.4%、"参与人员"得分55.6%、"制定的严谨性"得分78.1%、"表达的明晰性"得分83.3%、"应用性"得分55.2%、"编辑独立性"得分66.7%。该指南在临床推荐使用。在101条推荐中，高、中、低级证据分别占7条（6.9%）、31条（30.7%）和63条（62.4%）。

结论国内2018年发布的"肺血栓栓塞症诊治与预防指南"的方法学质量整体较高但证据级别不高，得分较低的"参与人员"和"应用性"两个领域仍需加强，特别是应纳入相应的经济学研究证据并进一步重视患者及公众的利益和偏好。

肺栓塞;指南;AGREE Ⅱ;循证医学;评价研究
ABSTRACT

ObjectiveTo assess the quality of the clinical practice guideline for diagnosis, treatment and prevention of pulmonary thromboembolism, 2018 in China, providing the references for updating and developing clinical practice guidelines of this field in the future.

MethodsThe quality of the clinical practice guideline for diagnosis, treatment and prevention of pulmonary thromboembolism, 2018 in China was assessed using the internationally recognized instrument Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ). AGREE Ⅱ instrument consisted of 23 items in six domains, followed by two overall assessment items. Each item was scored from 1 to 7. The final overall guideline quality considered all domain items.

ResultsThe scores of the six AGREE Ⅱ domains were: Scope and purpose 76.4%, Stakeholder involvement 55.6%, Rigor of development 78.1%, Clarity and presentation 83.3%, Applicability 55.2%, and Editorial independence 66.7%. The guideline was recommended for clinical use. Among the 101 recommendations, recommendations based on Levels High, Moderate and Low evidence accounted for 7 (6.9%), 31 (30.7%) and 63 (62.4%), respectively.

ConclusionThe methodological quality of the clinical practice guideline for diagnosis, treatment and prevention of pulmonary thromboembolism, 2018 in China was great, but the levels of evidence were not high. More efforts were urgently required to improve in Stakeholder involvement and applicability. Especially corresponding economic research evidence, as well as preferences of patients and the public should be considered in the future development of clinical practice guidelines.

Pulmonary embolism;Guidelines;AGREE Ⅱ;Evidence-based medicine;Evaluation studies
Jiang Mei, Email: mocdef.3ab61729iemgnaij
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引用本文

万铠瑞,赖宁,马杰羚,等. 2018年肺血栓栓塞症诊治与预防指南的质量评价[J]. 中华结核和呼吸杂志,2019,42(3)：213-218.

DOI:10.3760/cma.j.issn.1001-0939.2019.03.012

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肺血栓栓塞症（pulmonary thromboembolism，PTE）由来自静脉系统或右心的血栓阻塞肺动脉或其分支所致，主要来源于下肢的深静脉血栓形成（deep vein thrombosis，DVT），以肺循环和呼吸功能障碍为主要特征。近年来国内PTE和DVT诊断例数迅速增加，较20年前增长10~30倍，住院患者中PTE比例从1997年的0.26‰上升到2008年的1.45‰，临床漏诊与误诊情况严重 [ 1 ]。
基于此，中华医学会呼吸病学分会于2018年颁布了"肺血栓栓塞症诊治与预防指南" [ 2 ]（简称"PTE指南" ），进一步规范我国PTE的诊断、治疗与预防。指南质量影响其指导临床实践效果，然而目前尚未见报道评价该指南的质量。本研究运用国际公认的指南质量评价工具AGREE Ⅱ（appraisal of guidelines research and evaluation in Europe Ⅱ） [ 3 ]对PTE指南的方法学质量进行评价，旨在为今后指南的更新提供科学的改进意见，促进指南的临床应用水平，帮助临床医师做出规范合理的决策。
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备注信息
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江梅，Email： mocdef.3ab61729iemgnaij
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所有作者均声明不存在利益冲突
C
2016年广州医科大学教育科学规划课题 (2016)
广州市高等学校第九批教育科学改革研究项目 (2017E07)
广州医科大学2018—2019年度大学生科技创新项目 (2017A014)
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