Marta Maes-Carballo, Carlos Roberto Estrada-López, Carmen Martínez-Martínez, Claudia Alberca-Remigio, Cristina Cámara-Martínez, Benito Miguel Josa-Martínez, Rubén Trigueros
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引用次数: 0
摘要
背景：医学指南是提供高质量和标准化医疗服务的重要工具。我们分析了美容医学指南的质量：方法：我们采用前瞻性注册协议 (https://osf.io/8pdyv) 对数据库（MEDLINE、EMBASE、Web of Science、Scopus、CDSR）、科学协会网页和灰色文献进行了系统性审查，审查时间从开始到 2023 年 2 月，没有语言限制。分别使用 AGREE II（占最高分的百分比）、RIGHT（占总分 35 项的百分比）和共享决策（SDM）质量评估工具（31 项得分）对质量进行评估，评估结果一式两份：六份指南（86%）被归类为不推荐；一份（14%）经修改后被推荐，所有指南均被归类为报告质量差（7/7；100%）。AGREE II 和 RIGHT 的总体质量中位数分别为 27% (IQR: 26-43) 和 26% (IQR 15-36)。没有一份文件使用这些工具进行开发。SDM在几乎所有探讨过的指南中都显得多余：结论：美容医学和外科指南的质量较低，必须加以改进。需要改进的地方很多，尤其是在适用性、证据报告、建议、利益冲突、质量控制和 SDM 方面。这些指南需要基于系统回顾的严格方法，以确保基于证据的建议质量。
Quality in aesthetic medicine and surgery: a systematic review of clinical practice guidelines.
Background: Guidelines in medicine are essential tools to provide quality and standardised medical care. We analysed the quality of aesthetic medicine guidelines.
Methods: A systematic review with a prospective registration protocol (https://osf.io/8pdyv) of databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR), web pages of scientific societies and grey literature was done from inception to February 2023 and without language restrictions. Quality was evaluated using AGREE II (% of the maximum score), RIGHT (% of the total 35 items) and a shared decision making (SDM) quality assessment tool (31 items score) individually and in duplicate, respectively.
Results: Six (86%) guidelines were classified as not recommended; one (14%) was recommended with modifications, and all were classified as poorly reported (7/7; 100%). The median overall quality was 27% (IQR: 26-43) and 26% (IQR 15-36) for AGREE II and RIGHT, respectively. No document used these tools for its development. SDM appeared superfluity in almost all of the guidelines explored.
Conclusions: Aesthetic medicine and surgical guidelines had low quality and must be improved. There is a wide range of improvement, especially in applicability, reporting of evidence, recommendations, conflict of interest, quality control and SDM. These guidelines require a rigorous methodology based on systematic reviews to ensure quality evidence-based recommendations.
期刊介绍：
Colombia Médica is an international peer-reviewed medical journal that will consider any original contribution that advances or illuminates medical science or practice, or that educates to the journal''s’ readers.The journal is owned by a non-profit organization, Universidad del Valle, and serves the scientific community strictly following the International Committee of Medical Journal Editors (ICMJE) and the World Association of Medical Editors (WAME) recommendations of policies on publication ethics policies for medical journals.
Colombia Médica publishes original research articles, viewpoints and reviews in all areas of medical science and clinical practice. However, Colombia Médica gives the highest priority to papers on general and internal medicine, public health and primary health care.
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