国际临床指南评价工具的发展与启示

摘要

The background,features,dimension and contents of 22 international appraisal tools for clinical guidelines were analyzed,and their history,evolution,rules and problems were described,in order to provide the evidence for developing appraisal tools for domestic clinical guidelines. In the study,it was found that the guideline evaluation tools have been classified and there is a constant strive to achieve the balance between comprehensiveness and practicability. But the existing evaluation tools are insufficient for clinical practical contents of guidelines. The scoring system should be improved. In addition,conflicts of interest,value choice and patients' involvement should be considered increasingly, and should become an important part of the guideline evaluation tools.%以22个指南评价工具为研究对象，分析了国际临床指南评价工具的出台背景和特点、维度和条目内容，介绍了国外临床指南评价工具的发展历程，演变过程、发展规律和存在的问题，为开发本土化的临床指南评价工具提供依据。研究发现指南评价工具出现明显分类；指南评价工具正力求在全面性和实用性之间达到平衡；现有评价工具对指南的临床内容评价不足，评分系统有待改进；指南评价应越来越多地考虑价值取向与利益冲突，考虑病人的意向与参与。