摘要
目的:对全球范围内现有结直肠癌筛查指南进行系统梳理和质量评价。方法:采用系统综述的方法,对CNKI、万方、VIP、SinoMed、PubMed、Embase、Web of Science等中、英文数据库进行系统检索,检索时间截至2018年6月20日,同时检索了指南制订机构网站和主要搜索引擎,检索时间为2018年8月3日。对所有文献采用双人独立筛选、信息提取,由4名经培训的评价者使用AGREE Ⅱ(Appraisal of Guidelines for Research & Evaluation)工具对纳入指南进行质量评价。结果:共纳入符合标准的结直肠癌筛查指南46部,发布年代为1994—2018年,来自10个国家,5个地区。AGREE Ⅱ工具的评价结果显示,各指南质量在领域1(范围及目的)与领域4(表述清晰性)方面较高,在领域2(参与人员)方面中等,在领域3(过程严谨性)、领域5(适用性)和领域6(独立性)差异较大,循证指南(基于WHO指南制定标准进行定义)的质量总体优于一般指南。我国大陆现有结直肠癌筛查指南5部,均非循证指南,质量总体较低。结论:全球范围内结直肠癌筛查指南总体呈现数量多、质量较低的现状,中国大陆现有指南均不是循证指南,因此需要根据我国国情,建立高质量的结直肠筛查指南,为公共卫生实践提供可行的指导。
Objective: To systematically review and assess the quality of guidelines on colorectal cancer screening worldwide to provide guidance for the development of high-quality colorectal cancer screening guidelines in China's Mainland. Methods: CNKI, WanFang Data, VIP, SinoMed, PubMed, Embase, and Web of Science were systematically searched to identify guidelines on colorectal cancer screening from inception to Jun. 20 th , 2018, and so were some websites and major search engines about the deve- lopment of the guidelines from the existing literature (search date: Aug. 3 rd , 2018). Two experienced reviewers independently examined these abstracts and then extracted information, and the Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ) were used to evaluate the methodological quality of these guidelines by four well trained reviewers. Results: In this study, 46 guidelines published from 1994 to 2018 were finally included in our analysis from 10 countries and 5 regions, among which 5 were from China's Mainland. The quality of these guidelines was relatively high in domain 1 (scope and purpose) and domain 4 (clarity of presentation), and medium in domain 2 (stakeholder involvement). While in the other three domains (domain 3: rigour of development;domain 5: applicability;domain 6: editorial independence), the results were quite different among these guidelines. The quality of evidence-based guidelines (defined by the criteria based on World Health Organization guideline development handbook) was generally higher than that of the common guidelines. Existing guidelines from China's Mainland were not evidence-based guidelines, which were of low quality. Conclusion: The colorectal cancer screening guidelines all over the world are generally large in number, low in quality, different in statements, and so are the guidelines in China. There are no evidence-based guidelines in China's Mainland, which cannot provide effective guidance for colorectal cancer screening, so we need to pay more attention to the establi
作者
高乐
于树青
杨继春
马峻岭
詹思延
孙凤
GAO Le;YU Shu-qing;YANG Ji-chun;MA Jun-ling;ZHAN Si-yan;SUN Feng(Department of Epidemiology and Biostatistics,Peking University School of Public Health,Beijing 100191,China;Department of Cancer Epidemiology,Peking University Cancer Hospital & Institute,Beijing 100142,China;Center of Evidence-based Medicine and Clinical Research,Peking University,Beijing 100191,China)
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2019年第3期548-555,共8页
Journal of Peking University:Health Sciences
基金
国家自然科学基金(71673003)~~
关键词
结直肠癌
筛查
指南
系统综述
AGREE
Ⅱ
Colorectal cancer
Screening
Guideline
Systematic review
AGREE Ⅱ
