Guidelines on the Management of Acute Gastroenteritis/Diarrhea in Children: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 DINGXiang-yu ¹ ,  LIUYan-hui ¹ , FENGChao ¹ , LIRui-hong ¹ , ZHANGJing-li ²

1. Department of Pharmacy, Children's Hospital of Hebei Province, Shijiazhuang 050031, China;
2. Department of Respiration, Children's Hospital of Hebei Province, Shijiazhuang 050031, China;

Corresponding?author：

LIUYan-hui, Email: 360041200@qq.com

Keywords：

Gastroenteritis/Diarrhea; Children; Clinical practice guideline; AGREE II; Systematic review

DOI：

10.7507/1672-2531.20150151

Video：

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Objective To systematically review the methodological quality of clinical practice guidelines (CPGs) on the management of acute gastroenteritis/diarrhea in children, then to compare differences and similarities of drug recommendations, in order to provide references for clinical practice. Methods Guidelines concerning acute gastroenteritis/diarrhea in children were searched in CNKI, VIP, WanFang Data, CBM, PubMed and EMbase databases from inception to April 2015. The websites of GIN (Guidelines International Network), CGC (China Guideline Clearinghouse), NGC (National Guideline Clearinghouse), APP (American Academy of Pediatrics), NICE (National Institute for Health and Clinical Excellence) and the WHO (World Health Organization) were also searched for additional guidelines. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations of included guidelines were compared. Results A total of 9 guidelines on acute gastroenteritis/diarrhea in children were included. Among them, 3 guidelines were developed by USA, 1 by Malaysia, 1 by EU, 1 by UK, 1 by South Wales, 1 by Australia and 1 by South Africa. Five guidelines were evidence-based guidelines, and the other 4 were non-evidence-based guidelines. The average scores of guidelines in six domains of AGREE Ⅱ were 79% (clarity of presentations), 74% (scope and purpose), 44% (stakeholder involvement), 35% (rigor of development), 32% (applicability), and 30% (editorial independence), respectively. The recommendations of management and treatment were almost consistent. Conclusion The overall quality of included guidelines was not high. The domain scores of "clarity of presentations" and "scope and purpose" were higher, but the domain scores of "stakeholder involvement", "rigor of development", "applicability" and "editorial independence" needed to be improved. There is still no local guideline of acute gastroenteritis/diarrhea in children in China, so it's urgent to develop guideline that should be suite able for Chinese condition.

Citation： DINGXiang-yu, LIUYan-hui, FENGChao, LIRui-hong, ZHANGJing-li. Guidelines on the Management of Acute Gastroenteritis/Diarrhea in Children: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(8): 892-897. doi: 10.7507/1672-2531.20150151 Copy

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6.	王維, 陳青山, 劉治民. 應用Excel完成組內相關系數ICC的計算和評價. 中國衛生統計, 2008, 25(3):314-315.
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12.	Harris C, Wilkinson F, Mazza D, et al. Evidence based guideline for the management of diarrhoea with or without vomiting in children. J Aust Fam Physician, 2008, 37(6):22-29.
13.	Medical Services Commission. Oral rehydration therapy (ORT) in children. Agency for Healthcare Research and Quality. 2010, NGC-9468.
14.	Cincinnati Children's Hospital Medical Center. Best evidence statement (BEST). Use of Lactobacillus rhamnosus GG in children with acute gastroenteritis. Agency for Healthcare Research and Quality. 2011, NGC-8549.
15.	Wittenberg DF. Management guidelines for acute infective diarrhoea/gastroenteritis in infants. S Afr Med J, 2012, 102(2):104-107.
16.	張伶俐, 李幼平, 張川, 等. 中國兒童臨床指南現狀分析及循證臨床指南評價. 中國循證醫學雜志, 2011, 11(9):991-999.

1. Farthing M, Salam MA, Lindberg G, et al. Acute diarrhea in adults and children:a global perspective. J Clin Gastroenterol, 2013, 47(1):12-20.
2. Brouwers MC, Kho ME, Browman GP, et al. AGREE:Advancing guideline development, reporting and evaluation in healthcare. Can Med Assoc J, 2010, 182(8):839-842.
3. 陳尹, 胡世蓮, 李幼平, 等. 全球藥物干預治療單純性高血壓指南的系統評價. 中國循證醫學雜志, 2012, 12(10):1180-1194.
4. 李衛國, 李宇寧, 張秀敏, 等. AGREE Ⅱ評價9個兒童青少年維生素D臨床實踐指南及推薦意見共識和差異. 中國循證兒科雜志, 2012, 7(5):372-379.
5. 葉禮燕, 陳鳳欽. 腹瀉病診斷治療指南. 實用兒科臨床雜志, 2009, 24(19):1538-1540.
6. 王維, 陳青山, 劉治民. 應用Excel完成組內相關系數ICC的計算和評價. 中國衛生統計, 2008, 25(3):314-315.
7. Malaysian Paediatric Association. Guidelines on the management of acute diarrhoea in children, 2011.
8. National Collaborating Centre for Women's and Children's Health. Diarrhoea and vomiting caused by gastroenteritis:diagnosis, assessment and management in children younger than 5 years. RCOG Press, 2009.
9. Guarino A, Ashkenazi S, Gendrel D, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe:update 2014. J Pediatr Gastroenterol Nutr, 2014, 59(1):132-152.
10. Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for prevention and management of acute gasterenteritis (AGE) in children aged 2months to 18 years. Agency for Healthcare Research and Quality. 2011, NGC-8846.
11. NSW kid and Families. Infants and Children:Management of Acute Gastroenteritis, Fourth Edition, 2014.
12. Harris C, Wilkinson F, Mazza D, et al. Evidence based guideline for the management of diarrhoea with or without vomiting in children. J Aust Fam Physician, 2008, 37(6):22-29.
13. Medical Services Commission. Oral rehydration therapy (ORT) in children. Agency for Healthcare Research and Quality. 2010, NGC-9468.
14. Cincinnati Children's Hospital Medical Center. Best evidence statement (BEST). Use of Lactobacillus rhamnosus GG in children with acute gastroenteritis. Agency for Healthcare Research and Quality. 2011, NGC-8549.
15. Wittenberg DF. Management guidelines for acute infective diarrhoea/gastroenteritis in infants. S Afr Med J, 2012, 102(2):104-107.
16. 張伶俐, 李幼平, 張川, 等. 中國兒童臨床指南現狀分析及循證臨床指南評價. 中國循證醫學雜志, 2011, 11(9):991-999.

Chinese Journal of Evidence-Based Medicine

Guidelines on the Management of Acute Gastroenteritis/Diarrhea in Children: A Systematic Review

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