非酒精性脂肪性肝病临床指南和共识的质量评价及推荐意见比较研究 后印本

Краткое изложение: Objective To evaluate the methodological quality and reporting quality of guidance documents for non-alcoholic fatty liver disease using the AGREE II and RIGHT tools, summarize and compare the recommendations,and provide a reference for the development and reporting of future guidelines for non-alcoholic fatty liver disease.Methods PubMed, CNKI and other Chinese and English databases were searched by computer,with a search time frame of 1 September 2012 - 1 September 2022.Two trained evaluators independently evaluated the methodological and reporting quality of the included guidance documents using AGREE II and RIGHT respectively, and collated and compared the recommendations of the higher quality guidance documents.Results A total of 19 publications were included, including 12 guidelines and 7 consensus; 6 in Chinese and 13 in English; and 10 are developed using an evidence-based approach. The mean scores for each domain of AGREE II are 42.84% for scope and purpose, 31.43% for participants, 31.25% for rigour, 60.67% for clarity, 32.68% for application and 37.5% for independence. The average scores of RIGHT in each area are: basic information (59.65%), background (66.12%), evidence (42.11%), recommendations (39.85), review and quality assurance (17.11%), funding and conflict of interest statement and management (18.42%), and other aspects (47.37%).Evidence-based guidance documents has higher mean scores in AGREE II and higher quality of reporting in RIGHT than non-evidence-based guidance documents.Foreign guidance documents has higher mean scores in AGREE II and higher quality of reporting in RIGHT than domestic guidance documents.The main recommendations relate to screening and diagnosis, assessment, management (non-pharmacological and pharmacological treatment) and surgical treatment. Conclusion The methodological quality and reporting quality of the published guidance documents for NAFLD still need to be improved, and there are still gaps between domestic guidance documents and international guidance documents.The development of TCM guidance documents should follow an evidence-based approach.Further reference should be made to international standards such as AGREE II and RIGHT in the process of guideline development and reporting.Screening awareness for high-risk groups of NAFLD and a sound early non-invasive diagnosis and evaluation system should be established.Multi-dimensional treatment plans for lifestyle, liver function and metabolic disorders should be provided for patients NAFLD .