论文部分内容阅读
目的:系统评价全球肝癌筛查指南/共识的方法学质量，为我国肝癌筛查循证指南的制定提供参考依据。方法:系统检索PubMed、Cochrane Library、中国知网、万方数据知识服务平台、中国生物医学文献服务系统等中、英文数据库中肝癌筛查指南/共识，同时搜集相关指南制订机构作为补充。检索时间截至2020年6月30日。由2名研究人员独立进行文献筛选和信息提取。采用开发指南研究和评估工具Ⅱ（AGREE Ⅱ）和国际实践指南报告标准（RIGHT）对纳入的指南进行质量评价。结果:共纳入19部肝癌筛查指南/共识，发布时间为2003-2019年。AGREE Ⅱ评价结果显示，纳入指南的质量较高，其中9部指南推荐为A级，5部指南推荐为B级。各指南在范围和目的、参与人员、清晰性领域得分较高。RIGHT评价结果中以基本信息报告率最高（56.1%），背景（37.5%）和推荐意见（39.8%）报告质量尚可。证据（35.8%）、评审和质量保证（18.4%）、资金资助和利益冲突（22.4%）以及其他方面（21.0%）4个领域的质量待改善。结论:肝癌筛查指南质量尚可，但在证据、评审和质量保证、资金资助和利益冲突方面仍有待加强。我国尚缺乏肝癌筛查的独立的循证医学指南。“,”Objective:To systematically assess the quality of guidelines/consensus on live cancer screening globally and provide references for the formulation of evidence-based guideline on liver cancer screening in China.Methods:PubMed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, SinoMed, and other related guideline development institutions were searched to identify guidelines on live cancer screening before June 30, 2020. Two experienced reviewers screened literature and extracted data independently. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) and Reporting Items for Practice Guideline in Healthcare (RIGHT) were used to evaluate the quality of guidelines.Results:A total of 19 guidelines/consensus issued between 2003 and 2019 were included in this study. The quality of these guidelines was high according to AGREE Ⅱ, nine of which were recommended as level A, and the other five were graded as level B. Each guidance scored higher in scope and purpose, stakeholder involvement, and clarity of presentation. The reporting quality of basic information with 56.1% reporting rate was the highest based on RIGHT. The reporting quality of background (37.5%) and recommendations (39.8%) were acceptable. However, evidence (35.8%), review and quality assurance (18.4%), funding and declaration and management of interests (22.4%) and other information (21.0%) still need to be improved.Conclusions:Although the quality of screening guidelines for liver cancer is acceptable, the evidence, review and quality assurance, and funding and declaration and management of interests still need to be strengthened. There is still a lack of solely evidence-based medical screening guidelines for liver cancer in China.