癫痫指南的目前状态：一项系统评价_Journal of Epilepsy

Authors：

SauroKM , WiebeS , DunkleyC , 高慧 , 慕洁

Corresponding author：

Keywords：

癫痫指南; 循证医学; 临床实践指南

DOI：

10.7507/2096-0247.20170086

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国际抗癫痫联盟(ILAE)癫痫指南工作小组创立于2011年，由14名国际成员组成，以系统评价的方式，鉴定和评估国际癫痫临床指南的质量，并确定仍需要发展方面的缺口。使用广泛的搜索方式，在6个电子数据库(如Medline和Embase)进行搜索，不包含任何语言及研究设计的限制。之后以系统评价的方式评价文献(1985-2014)。同时也检索了6个灰色文献数据库(如美国神经病学学会及ILAE)以最小化发表偏倚。2名评审者独立筛选摘要，回顾全文，并且进行数据提取。进行描述性统计及Meta分析。共计查找出10 926篇摘要。其中410篇文献被选出进行全文回顾，63篇满足指南的合格标准。在这些纳入的文献中，英文54篇，其他语言9篇(法语、西班牙语和意大利语)。所有指南中，29%并未明确其适应的年龄群体，27%针对成年人，22%仅针对儿童，还有6%特殊指出针对癫痫女性患者。评价纳入的指南主要针对癫痫持续状态的临床实践(n=7)、第一次痫性发作(n=6)、耐药性癫痫(n=5)和热性惊厥(n=4), 以及其他。大多数指南为治疗相关(n=35)或者诊断相关(n=16)。使用1~7分评分表(最高为7分)来评估指南的质量，整体来看质量为中等(4.99±1.05)。发现在一些主题中存在缺口(如老年癫痫)，并且发现方法学质量方面存在相当的异质性。此项研究的发现为健康从业者关怀癫痫患者提供了有价值的资源，有助于指引优先制定、发展和传播未来的癫痫相关指南。

Citation： SauroKM, WiebeS, DunkleyC, 高慧, 慕洁. 癫痫指南的目前状态：一项系统评价. Journal of Epilepsy, 2017, 3(6): 525-533. doi: 10.7507/2096-0247.20170086 Copy

1.	Field MJ, Lohr KN. Guidelines for Clinical Practice: From Development to Use. Washington, DC: The National Academies Press, 1992.
2.	Graham R, Mancher M, Wolman DM, et al. Clinical Practice Guidelines We Can Trust. Washington, DC: The National Academies Press, 2011.
3.	Field MJ, Lohr KN. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press, 1990.
4.	Turner T, Misso M, Harris C, et al. Development of evidence-based clinical practice guidelines (CPGs): comparing approaches. Implement Sci, 2008, 3: 45.
5.	WHO Handbook for guideline development.World Health Organization. Geneva, Switzerland: World Health Organization, 2012.
6.	Davis D, Goldman J, Palda VA. Handbook on clinical practice guidelines. Toronto, ON: Canadian Medical Association, 2007.
7.	Shekelle PG, Woolf SH, Eccles M, et al. Developing clinical guidelines. West J Med, 1999, 170(6):348-351.
8.	Gronseth GS, Woodroffe LM, Getchius TSD. Clinical practice guideline process manual. St. Paul, MN: American Academy of Neurology, 2011.
9.	Institute of Medicine. Clinical practice guidelines we can trust. Washington, DC: National Academies Press, 2011.
10.	Fountain NB, Van Ness PC, Swain-Eng R, et al. Quality improvement in neurology: AAN epilepsy quality measures: report of the Quality Measurement and Reporting Subcommittee of the American Academy of Neurology. Neurology, 2011, 76(1):94-99.
11.	Mary JE, Catharyn TL, Andrea MS, et al. Epilepsy Across the Spectrum: Promoting Health and Understanding. Washington, DC: The National Academies Press, 2012.
12.	Lugtenberg M, Burgers JS, Westert GP. Effects of evidence-based clinical practice guidelines on quality of care: a systematic review. Qual Saf Health Care, 2009, 18(5): 385-392.
13.	Qin D, Leef G, Alam MB, et al. Patient outcomes according to adherence to treatment guidelines for rhythm control ofatrial fibrillation. J Am Heart Assoc, 2015, 4(4): 1-9.
14.	Wiebe S. Still an elusive target: guiding practice for epilepsy surgery. Neurology, 2010, 75(8): 678-679.
15.	Davis J, Roberts R, Davidson D, et al. Implementation strategies for a Scottish national epilepsy guideline in primary care: results of the Tayside Implementation of Guidelines in Epilepsy Randomized (TIGER) trial. Epilepsia, 2004, 45(1):28-34.
16.	Fitzsimons M, Normand C, Varley J, et al. Evidence-based models of care for people with epilepsy. Epilepsy Behav, 2012, 23(1):1-6.
17.	Dunkley C, Cross JH. NICE guidelines and the epilepsies: how should practice change. Arch Dis Child, 2006, 91(6):525-528.
18.	Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): e839-e842.
19.	AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care, 2003, 12(1): 18-23.
20.	Kontopantelis E, Reeves D. Meta an random-effects meta-analysis. Stata J, 2010, 10: 395-407.
21.	Nyaga VN, Arbyn M, Aerts M. Metaprop: a stata comm. and toper form meta-analysis of binomial data. Arch Public Health, 2014, 72(1): 39.
22.	Stata Corp. Stata Statistical Software: Release11. College Station, TX: StataCorp, LP, 2011.
23.	Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet, 1993, 342(8883): 1317-1322.
24.	Cabana MD, Rand CS, Powe NR, et al. Why don't physicians follow clinical practice guidelines a framework for improvement. JAMA, 1999, 282(15): 1458-1465.
25.	Browman GP, Newman TE, Mohide EA, et al. Progress of clinical oncology guidelines development using the practice guidelines development cycle: the role of practitioner feedback. J Clin Oncol, 1998, 16(3): 1226-1231.
26.	Sauro K, Wiebe S, Perucca E, et al. Developing clinical practice guide-lines for epilepsy: a report from the ILAE epilepsy guidelines working group. Epilepsia, 2015, 56(12):1859-1869.
27.	Martinez Garcia L, Sanabria AJ, Garcia Alvarez E, et al. The validity of recommendations from clinical guidelines: a survival analysis. CMAJ, 2014, 186(16): 1211-1219.
28.	Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE commission on classification and terminology, 2005-2009. Epilepsia, 2010, 51(4): 676-685.

1. Field MJ, Lohr KN. Guidelines for Clinical Practice: From Development to Use. Washington, DC: The National Academies Press, 1992.
2. Graham R, Mancher M, Wolman DM, et al. Clinical Practice Guidelines We Can Trust. Washington, DC: The National Academies Press, 2011.
3. Field MJ, Lohr KN. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press, 1990.
4. Turner T, Misso M, Harris C, et al. Development of evidence-based clinical practice guidelines (CPGs): comparing approaches. Implement Sci, 2008, 3: 45.
5. WHO Handbook for guideline development.World Health Organization. Geneva, Switzerland: World Health Organization, 2012.
6. Davis D, Goldman J, Palda VA. Handbook on clinical practice guidelines. Toronto, ON: Canadian Medical Association, 2007.
7. Shekelle PG, Woolf SH, Eccles M, et al. Developing clinical guidelines. West J Med, 1999, 170(6):348-351.
8. Gronseth GS, Woodroffe LM, Getchius TSD. Clinical practice guideline process manual. St. Paul, MN: American Academy of Neurology, 2011.
9. Institute of Medicine. Clinical practice guidelines we can trust. Washington, DC: National Academies Press, 2011.
10. Fountain NB, Van Ness PC, Swain-Eng R, et al. Quality improvement in neurology: AAN epilepsy quality measures: report of the Quality Measurement and Reporting Subcommittee of the American Academy of Neurology. Neurology, 2011, 76(1):94-99.
11. Mary JE, Catharyn TL, Andrea MS, et al. Epilepsy Across the Spectrum: Promoting Health and Understanding. Washington, DC: The National Academies Press, 2012.
12. Lugtenberg M, Burgers JS, Westert GP. Effects of evidence-based clinical practice guidelines on quality of care: a systematic review. Qual Saf Health Care, 2009, 18(5): 385-392.
13. Qin D, Leef G, Alam MB, et al. Patient outcomes according to adherence to treatment guidelines for rhythm control ofatrial fibrillation. J Am Heart Assoc, 2015, 4(4): 1-9.
14. Wiebe S. Still an elusive target: guiding practice for epilepsy surgery. Neurology, 2010, 75(8): 678-679.
15. Davis J, Roberts R, Davidson D, et al. Implementation strategies for a Scottish national epilepsy guideline in primary care: results of the Tayside Implementation of Guidelines in Epilepsy Randomized (TIGER) trial. Epilepsia, 2004, 45(1):28-34.
16. Fitzsimons M, Normand C, Varley J, et al. Evidence-based models of care for people with epilepsy. Epilepsy Behav, 2012, 23(1):1-6.
17. Dunkley C, Cross JH. NICE guidelines and the epilepsies: how should practice change. Arch Dis Child, 2006, 91(6):525-528.
18. Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): e839-e842.
19. AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care, 2003, 12(1): 18-23.
20. Kontopantelis E, Reeves D. Meta an random-effects meta-analysis. Stata J, 2010, 10: 395-407.
21. Nyaga VN, Arbyn M, Aerts M. Metaprop: a stata comm. and toper form meta-analysis of binomial data. Arch Public Health, 2014, 72(1): 39.
22. Stata Corp. Stata Statistical Software: Release11. College Station, TX: StataCorp, LP, 2011.
23. Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet, 1993, 342(8883): 1317-1322.
24. Cabana MD, Rand CS, Powe NR, et al. Why don't physicians follow clinical practice guidelines a framework for improvement. JAMA, 1999, 282(15): 1458-1465.
25. Browman GP, Newman TE, Mohide EA, et al. Progress of clinical oncology guidelines development using the practice guidelines development cycle: the role of practitioner feedback. J Clin Oncol, 1998, 16(3): 1226-1231.
26. Sauro K, Wiebe S, Perucca E, et al. Developing clinical practice guide-lines for epilepsy: a report from the ILAE epilepsy guidelines working group. Epilepsia, 2015, 56(12):1859-1869.
27. Martinez Garcia L, Sanabria AJ, Garcia Alvarez E, et al. The validity of recommendations from clinical guidelines: a survival analysis. CMAJ, 2014, 186(16): 1211-1219.
28. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE commission on classification and terminology, 2005-2009. Epilepsia, 2010, 51(4): 676-685.

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Journal of Epilepsy

癫痫指南的目前状态：一项系统评价

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