《中国康复理论与实践》

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (12): 1365-1376.doi: 10.3969/j.issn.1006-9771.2023.12.001

• 专题 康复循证研究 • 上一篇    下一篇

2022年医学期刊发表中国康复医学指南和共识的科学性、透明性和适用性评级

刘小燮1a,2,3,4, 褚红玲1b,2, 刘美2,5, 郭艾鑫2,6, 王思远2,7, 曾凡硕2,8, 江山2,7, 谢欲晓3,7, 周谋望1a,2()   

  1. 1.北京大学第三医院，a.康复医学科；b. 临床流行病学研究中心，北京市 100191
    2.STAR工作组康复医学专科委员会，北京市 100191
    3.世界卫生组织国际分类家族中国合作中心，北京市 100068
    4.北京市康复医疗质量控制和改进中心，北京市 100191
    5.兰州大学第二医院康复医学科，甘肃兰州市 730030
    6.北京医院康复医学科，北京市 100730
    7.中日友好医院康复医学科，北京市 100029
    8.山东大学第二医院康复医学科，山东济南市 250033
  • 收稿日期:2023-10-15 修回日期:2023-11-09 出版日期:2023-12-25 发布日期:2023-12-28
  • 通讯作者: 周谋望(1960-)，男， 汉族，湖北武汉市人，硕士，教授、主任医师，博士研究生导师，主要研究方向：脊髓损伤康复、肌肉骨骼康复等。E-mail： zhoumouwang@163.com
  • 作者简介:刘小燮(1986-)，女，汉族，北京市人，博士，主治医师，主要研究方向：脊髓损伤康复、呼吸与危重症康复、临床实践指南方法学。
  • 基金资助:
    1.北京市科技重大专项(D181100000318004);2.中国科学技术协会青年人才托举工程(YESS20180055)

Scientific, transparent and applicable rankings of Chinese guidelines and consensus of rehabilitation medicine published in medical journals in 2022

LIU Xiaoxie1a,2,3,4, CHU Hongling1b,2, LIU Mei2,5, GUO Aixin2,6, WANG Siyuan2,7, ZENG Fanshuo2,8, JIANG Shan2,7, XIE Yuxiao3,7, ZHOU Mouwang1a,2()   

  1. 1. a. Department of Rehabilitation Medicine; b. Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
    2. Rehabilitation Medicine Specialist Committee of the STAR Working Groups, Beijing 100191, China
    3. WHO-FICs Collaborating Center in China, Beijing 100068, China
    4. Beijing Municipal Center of Healthcare Quality Control and Improvement in Rehabilitation Medicine, Beijing 100191, China
    5. Department of Rehabilitation Medicine, Lanzhou University Second Hospital, Lanzhou, Gansu 730030, China
    6. Department of Rehabilitation Medicine, Beijing Hospital, Beijing 100730, China
    7. Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing 100029, China
    8. Department of Rehabilitation Medicine, the Second Hospital of Shandong University, Ji'nan, Shandong 250033, China
  • Received:2023-10-15 Revised:2023-11-09 Published:2023-12-25 Online:2023-12-28
  • Contact: ZHOU Mouwang, E-mail: zhoumouwang@163.com
  • Supported by:
    Beijing Muncipal Science and Technology Major Project(D181100000318004);China Association for Science and Technology Young Elite Scientists Sponsorship Program by Cast(YESS20180055)

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摘要：

目的 对2022年期刊发表中国康复医学指南和共识进行科学性、透明性和适用性评级(STAR)。

方法 在中国知网、万方数据、中国生物医学数据库、中华医学期刊网、PubMed和Web of Science数据库中，检索制订机构为中国单位或牵头人为中国学者的指南和共识，时间范围2022年，筛选康复医学领域指南和共识，采用STAR进行评级。

结果 共纳入7部指南和11部共识，STAR评级11.7~69.6分，中位数25.9分，平均28.3分。指南与共识之间STAR总分存在显著性差异(U = 12.000, P = 0.014)。评分比例最高的3个领域分别为推荐意见(73.6%)、证据(39.5%)和其他(33.3%)，最低的3个领域分别为计划书(1.4%)、临床问题(12.5%)和利益冲突(13.9%)。评分比例最高的条目包括说明了参与人员的机构(94.4%)、主要推荐意见有明确的参考文献(94.4%)、说明了推荐意见实施过程中的注意事项(88.9%)、明确列出了推荐意见(75%)；较低的条目包括说明了资助在指南制订中的作用(0)，提供详细的利益冲突管理办法(0)，提供不同用户版本的指南(0)，以图片、视频等其他形式发布指南或推荐意见(0)，撰写了计划书(2.8%)，评价证据的偏倚风险或方法学质量(2.8%)，说明了参与人员的职责(5.6%)，说明了临床问题遴选方法(5.6%)，临床问题以PICO形式解构(5.6%)，通过指南文库、会议、网络等多平台发布指南(5.6%)，说明指南推荐意见未受资助影响(8.3%)。

结论 中国康复医学领域指南和共识的整体质量有待提高，应按照要求规范开展指南制定工作。

关键词: 康复医学, 指南, 共识, 评价

Abstract:

Objective To evaluate the Chinese guidelines and consensus of rehabilitation medicine published in the medical journals in 2022 using Scientific, Transparent and Applicable Rankings (STAR).

Methods Guidelines and consensus which were developed by Chinese institutions or led by Chinese scholars were retrieved in databases of CNKI, Wanfang Data, CBM, Chinese Medical Journal Network, PubMed and Web of Science, in 2022, followed by screening for rehabilitation medicine field. The literature were rated with STAR.

Results Seven guidelines and eleven consensuses were included. The STAR scores ranged from 11.7 to 69.6, with a median score of 25.9 and mean score of 28.3. There was a significant difference in the total score between guidelines and consensus (U= 12.000, P = 0.014). The score ratio was high in the domains of recommendations (73.6%), evidence (39.5%) and others (33.3%), while it was low in the domains of protocol (1.4%), clinical questions (12.5%) and conflicts of interest (13.9%). The score ratio was high in the items of listing the institutional affiliations of all individuals involved in developing the guideline (94.4%), identifying the references for evidence supporting the main recommendations (94.4%), indicating the considerations (e.g., adverse effects) in clinical practice when implementing the recommendations (88.9%), and making the recommendations clearly identifiable, e.g., in a table, or using enlarged or bold fonts (75%); and it was low in the items of describing the role of funder(s) in the guideline development (0), indicating information about the evaluation and management of conflicts of interest (0), providing tailored editions of the guidelines for different groups of target users (0), presenting the guideline or recommendations visually, such as with figures or videos (0), providing details of the guideline protocol (2.8%), assessing the risk of bias or methodological quality of the included studies (2.8%), describing the responsibilities of all individuals or sub-groups involved in developing the guideline (5.6%), indicating how the clinical questions were selected and sorted (5.6%), formating clinical questions in PICO or other formats (5.6%), making the guideline accessible through multiple platforms (5.6%), and declaring that the funder(s) did not influence the guideline's recommendations (8.3%).

Conclusion The quality of current clinical practice guidelines and consensus of rehabilitation medicine is poor, which should be developed in accordance with the relevant standards.

Key words: rehabilitation medicine, guidelines, consensus, evaluation

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