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首页> 外文期刊>Revista da Sociedade Brasileira de Medicina Tropical >Therapeutic drug monitoring of benznidazole and nifurtimox: a systematic review and quality assessment of published clinical practice guidelines
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Therapeutic drug monitoring of benznidazole and nifurtimox: a systematic review and quality assessment of published clinical practice guidelines

机译:苯并硝唑和硝呋替莫的治疗药物监测:已发表临床实践指南的系统评价和质量评估

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Abstract The pharmacological management of adults with chronic-phase Chagas disease is challenging despite it being the recent focus of extensive research. One of the challenges in the current clinical practice guidelines (CPGs) landscape is the existence of non-evidence-based recommendations for the use of laboratory tests in treatment monitoring. This study aimed to systematically assess the quality and consistency of recommendations of CPGs on the pharmacological management of adults with chronic-phase Chagas disease. Systematic literature searches were conducted in MEDLINE, EMBASE, SciELO and Google to identify all published CPGs relevant to the pharmacological management of Chagas disease, between January 2010 and March 2016. Three independent reviewers assessed the quality of each CPG using the Appraisal of Guidelines Research and Evaluation (AGREE) II instrument. A total of five CPGs were included and the overall quality of the guidelines for therapeutic drug monitoring of Chagas disease was moderate-to-low. There was considerable variation in the quality of the CPGs across the AGREE II domains. The domains of scope/purpose, stakeholder involvement, and clarity of presentation were rated well, and the domains of applicability and editorial independence received poor ratings. This review showed that the methodological quality of CPGs for Chagas disease was generally inappropriate, and there was no explicit link between the best available evidence and current recommendations.
机译:摘要成人慢性恰加斯病的药理管理是一项艰巨的挑战,尽管它是近期广泛研究的重点。当前临床实践指南(CPG)面临的挑战之一是在治疗监测中使用基于实验室检查的非循证医学建议。这项研究旨在系统地评估CPG在成人慢性Chagas病的药理管理中建议的质量和一致性。在2010年1月至2016年3月之间,在MEDLINE,EMBASE,SciELO和Google中进行了系统的文献检索,以鉴定与查加斯病的药理管理有关的所有已发布CPG。三名独立审阅者使用指南研究和评估对每个CPG的质量进行了评估评估(AGREE)II仪器。总共包括五种CPG,南美锥虫病治疗药物监测指南的总体质量为中到低。跨AGREE II域的CPG质量存在很大差异。范围/目的,利益相关者的参与以及表达的清晰性等领域得到了很好的评价,而适用性和编辑独立性等方面得到了较差的评价。这项审查表明,用于查加斯病的CPG的方法学质量通常是不合适的,并且最佳证据和当前建议之间没有明确的联系。

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