儿童青少年糖尿病临床循证指南质量AGREEⅡ评价情况

摘要
图/表
参考文献(20)
相关文章 (15)

全文: PDF (526 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的评价儿童青少年糖尿病临床循证指南质量，比较各指南药物治疗差异，为临床医师及药师提供用药参考。方法计算机检索中国知网、万方数据库、维普、中国生物医学文献数据库、PubMed、Embase及医脉通官网、GIN、AAP、NGC、NICE等网站，检索时限为建库至2018年12月。纳入儿童青少年糖尿病临床循证指南，应用指南研究与评价（AGREEⅡ）对指南质量进行评价，对药物治疗推荐意见进行比较。结果纳入指南4篇，分别为美国AAP、国际ISPAD、马来西亚MaHTAS、英国NICE，4篇指南总体质量相对较高，其中MaHTAS与NICE指南质量评级为A级，而AAP及ISPAD指南质量评级为B级。各领域中“清晰性”与“范围与目的”得分较高，而“严谨性”与“应用性”得分相对较低，各指南药物推荐意见基本一致。结论纳入指南质量相对较高，我国目前尚缺乏儿童糖尿病临床循证指南，建议采用循证制订的方法，制订符合我国国情的循证指南，为我国广大糖尿病患儿治疗提供依据。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	丁翔宇1 王建欣2 张古英1 刘艳辉1

关键词 ：糖尿病, 临床指南, 儿童, 青少年, 指南研究与评价

Abstract：Objective To evaluate the quality of clinical evidence-based guidelines for diabetes in children and adolescents, and to compare the differences in drug treatment between the guidelines, so as to provide references for clinicians and pharmacists. Methods China National Knowledge Infrastucture, Wanfang Data, VIP, CBM database, PubMed database, Excerpta Medica Database and relevant websites such as medlive.cn, GIN, AAP, NGC, NICE were searched by computer ranged from the beginning of the database to the end of December 2018. The Appraisal of Guidelines for Research & Evaluation (AGREEⅡ) instrument was used to evaluate the quality of clinical evidence-based guidelines for diabetes in children and adolescents for the sake of the comparison of recommendations on drug therapy. Results A total of four guidelines were included respectively from the United States AAP, International ISPAD, Malaysia MaHTAS and the United Kingdom NICE. The overall quality of the guidelines was relatively high. Among these guidelines, the quality of MaHTAS and NICE were rated A, while the quality of AAP and ISPAD guidelines were rated B. In all fields, “clarity of presentation” and “scope and purpose” scored well，but the scores of “rigor of development” and “applicability” were relatively low. The drug recommendations in each guideline were basically consistency. Conclusion The quality of inclusion guidelines is relatively high. There is still a lack of evidence-based clinical guidelines for children with diabetes in China. It is suggested that evidence-based methods should be adopted to formulate evidence-based guidelines in line with China′s national conditions so as to provide a basis for the treatment of diabetic children in China.

Key words： Diabetes mellitus Clinical guideline Children Adolescents The Appraisal of Guidelines for Research & EvaluationⅡ

基金资助:河北省卫生计生委医学科学研究重点课题计划项目（20150567）。

通讯作者: 王建欣（1982-），女，硕士，副主任药师，主要从事临床药学工作。

作者简介: 丁翔宇（1981-），女，硕士，副主任药师，主要从事临床药学工作。

引用本文:

丁翔宇1 王建欣2 张古英1 刘艳辉1. 儿童青少年糖尿病临床循证指南质量AGREEⅡ评价情况[J]. 中国医药导报, 2019, 16(27): 65-68.
DING Xiangyu1 WANG Jianxin2 ZHANG Guying1 LIU Yanhui1. Quality appraisal of clinical evidence-based guidelines for diabetes in children and adolescents based on AGREE Ⅱ. 中国医药导报, 2019, 16(27): 65-68.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I27/65

[1] IDF Diabetes Atlas [M]. 8th ed. Brussels，Belgium：International Diabetes Federation，2017.
[2] Zeitler P，Arslanian S，Fu JF. Type 2 diabetes mellitus in youth [J]. Pediatr Diabetes，2018，19（suppl 27）：26-28.
[3] Farsani SF，Van Der Aa M，Van Der Vorst M，et al. Global trends in the incidence and prevalence of type 2 diabetes in children and adolescents：a systematic review and evaluation of methodological approaches [J]. Diabetologia，2013， 56（7）：1471-1488.
[4] 胡志强，张伶俐，李幼平，等.新生儿细菌性脑膜炎药物治疗循证指南的系统评价[J].中国循证医学杂志，2015， 15（1）：28-35.
[5] 陈尹，胡世莲，李幼平，等.全球药物干预治疗单纯性高血压指南的系统评价[J].中国循证医学杂志，2012，12（10）：1180-1194.
[6] 归舸，蒋璐灿，张伶俐.全球现有儿童特发性血小板减少性紫癜指南的循证评价[J].中国药房，2018，29（4）：541-546.
[7] Copeland KC，Silverstein J，Moore KR，et al. Management of newly diagnosed type 2 diabetes mellitus （T2DM） in children and adolescents [J]. Pediatrics，2013，131（2）：364-382.
[8] Acerini CL，Codner E，Craig ME，et al. ISPAD clinical practice consensus guidelines 2018 [J]. Pediatr Diabetes，2018， 19（Suppl 12）：1-338．
[9] Management of Type 1 Diabetes Mellitus in Children & Adolescents. Malaysia Health Technology Assessment Section （MaHTAS） [EB/OL]. 2015. http：//www.acadmed.org.my.
[10] Diabetes （type 1 and type 2） in children and young people：diagnosis and management（NG18）. NICE guideline Published [EB/OL]. 2015. nice.org.uk/guidance/ng18.
[11] Redon I，Beltrand J，Martin D，et al. Changes in insulin therapy regimens over 10 yr in children and adolescents with type 1 diabetes attending diabetes camps [J]. Pediatr Diabetes，2014，15（5）：329-335.
[12] Rendell M. Premix insulins in type 1 diabetes：the coming of degludec/aspart [J]. Expert Opin Drug Metab Toxicol，2019，15（4）：341-348.
[13] Smith JD，Mills E，Carlisle SE. Treatment of pediatric type 2 diabetes [J]. Ann Pharmacother，2016，50（9）：768-777.
[14] Zeitler P，Hirst K，Pyle L，et al. TODAY Study Group. A clinical trial to maintain glycemic control in youth with type 2 diabetes [J]. N Engl J Med，2012，366（24）：2247-2256.
[15] Food and Drug Administration. FDA drug safety communication：FDA eliminates the Risk Evaluation and Mitigation Strategy （REMS） for rosiglitazone-containing diabetes medicines [EB/OL]. 2016. http：//www.fda.gov/Drugs/DrugSafety/ucm476466.htm.
[16] Leonard CE，Bilker WB，Brensinger CM，et al. Severe hypoglycemia in users of sulfonylurea antidiabetic agents and antihyperlipidemics [J]. Clin Pharmacol Ther，2016， 99（5）：538-547.
[17] Hellman B，Dansk H，Grapengiesser E. Sulfonylurea blockade of KATP channels unmasks a distinct type of glucose-induced Ca2+ decrease in pancreatic β-cells [J]. Pancreas，2017，46（4）：467-475.
[18] 中华医学会儿科学分会内分泌遗传代谢学组《中华儿科杂志》编辑委员会.儿童及青少年糖尿病的胰岛素治疗指南（2010年版）[J].中华儿科杂志，2010，48（6）：431-435.
[19] 中华医学会儿科学分会内分泌遗传代谢学组.儿童青少年２型糖尿病诊治中国专家共识[J].中华儿科杂志，2017，55（6）：404-410.
[20] 张伶俐，李幼平，张川.中国儿童临床指南现状分析及循证临床指南评价[J].中国循证医学杂志，2011，11（9）：991-999.