Quality evaluation of clinical guidelines and consensus for adult AIDS_Chinese Journal of Evidence-Based Medicine

Authors：

SHA Yinyin ¹ ,  XU Liran ² , MA Xiuxia ² , MENG Pengfei ^1,2 , SHAO Cancan ¹ , WANG Xueting ¹ , JIA Yandan ¹

1. Henan University of Chinese Medicine, Zhengzhou 450000, P. R. China;
2. The First Affiliated Hospital of Henan University of TCM, Zhengzhou 450008, P. R. China;

Corresponding?author：

XU Liran, Email: xuliran666@sina.com

Keywords：

AIDS; Clinical guideline; Consensus; Quality assessment; AGREE Ⅱ; RIGHT

DOI：

10.7507/1672-2531.202202085

Video：

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Objective To evaluate the methodological and reporting quality of clinical guidelines and consensus for adult AIDS. Methods Databases including PubMed, EMbase, Web of Science, CBM, WanFang Data and CNKI were electronically searched and major guideline websites such as GIN, NICE, NGC and Yimaitong were also searched to collect guidelines and consensus for adult AIDS from inception to December 2021. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. Four reviewers evaluated the methodological and reporting quality of the included guidelines and consensus by using AGREE Ⅱ and RIGHT, respectively. Results A total of 17 adult AIDS guidelines and consensus were included. The average scores of AGREE Ⅱ in various domains were 59.48% for scope and purpose, 37.17% for stakeholder involvement, 30.76% for rigor of development, 74.75% for clarity of presentation, 35.54% for applicability, and 50.49% for editorial independence. The items with the highest reporting rate among the RIGHT evaluation items were 1a, 1b and 1c (100.00%), followed by 3 and 4 (94.12%), 13a and 13b (88.24%), 7b and 11a (76.47%), and 5 (64.71%), and the remaining items were all reported below 60%. Results of subgroup analysis showed that the clarity of presentation, applicability and editorial independence of the guidelines for adult AIDS expressed in AGREE Ⅱ and the average score of RIGHT were higher than those of the consensuses for adult AIDS; the average scores of guidelines and consensuses based on evidence-based medicine in five domains of AGREE Ⅱ (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation and applicability) and RIGHT were higher than those based on expert opinions or reviews. The foreign guidelines and consensus had higher average scores in the six domains of AGREE Ⅱ and the RIGHT score than the domestic guidelines. Conclusion The methodological quality and reporting quality of the published clinical guidelines and consensuses for adult AIDS is low; in particular, there is a certain gap between the national and international guidelines and consensuses. It is suggested that future guideline developers should refer to international standards, such as AGREE Ⅱ and RIGHT, formulate high-quality guidelines and promote their application to better regulate the diagnosis and treatment of adult AIDS.

Citation： SHA Yinyin, XU Liran, MA Xiuxia, MENG Pengfei, SHAO Cancan, WANG Xueting, JIA Yandan. Quality evaluation of clinical guidelines and consensus for adult AIDS. Chinese Journal of Evidence-Based Medicine, 2022, 22(6): 706-715. doi: 10.7507/1672-2531.202202085 Copy

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2.	Joint United National Programme on HIV/AIDS. Global AIDS strategy 2021-2026. Available at: https://www.unaids.org/en/Global-AIDS-Strategy-2021-2026.
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5.	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.
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8.	張雪芹, 鄧宏勇. 循證醫學數據庫: 現狀與趨勢. 中國循證醫學雜志, 2021, 21(6): 621-627.
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10.	Hoydonckx Y, Kumar P, Flamer D, et al. Quality of chronic pain interventional treatment guidelines from pain societies: assessment with the AGREE II instrument. Eur J Pain, 2020, 24(4): 704-721.
11.	Rachlis AR, Zarowny DP, Canadian HIV Trials Network Antiretroviral Working Group. Guidelines for antiretroviral therapy for HIV infection. CMAJ. 1998. 158(4): 496-505.
12.	Antinori A, Ammassari A, Torti C, et al. Italian consensus statement on management of HIV-infected individuals with advanced disease na?ve to antiretroviral therapy. Infection, 2009, 37(3): 270-282.
13.	鄭毓芳, 康來儀, 潘孝彰, 等. 人類免疫缺陷病毒感染特殊人群抗病毒治療方案共識. 內科理論與實踐, 2013, 8(2): 137-146.
14.	中華醫學會熱帶病與寄生蟲學分會艾滋病學組. 人類免疫缺陷病毒/艾滋病抗病毒治療換藥策略專家共識. 中華傳染病雜志, 2019, (7): 397-402.
15.	中華中醫藥學會防治艾滋病分會. 艾滋病并發周圍神經病變中西醫協同治療專家共識. 中醫學報, 2020, 35(6): 1212-1214.
16.	王輝, 李在村, 趙紅心, 等. 人類免疫缺陷病毒(HIV)抗病毒治療二聯簡化療法專家共識. 中國艾滋病性病, 2020, 26(3): 331-334, 336.
17.	中國性病艾滋病防治協會學術委員會外科學組, 中華醫學會熱帶病與寄生蟲學分會外科學組. 中國人類免疫缺陷病毒感染者圍手術期抗病毒治療專家共識. 中華實驗和臨床感染病雜志(電子版), 2019, 13(1): 1-5.
18.	Centers for Disease Control and Prevention. Report of the NIH panel to define principles of therapy of HIV infection and guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. MMWR, 1998, 47(RR-5): 43-82.
19.	AIDS Society of India. API consensus guidelines for use of antiretroviral therapy in adults (API-ART guidelines). J Assoc Physicians India, 2006, 54: 57-74.
20.	中華中醫藥學會防治艾滋病分會. 艾滋病中醫診療指南(2013版). 中醫學報, 2014, 29(5): 617-620.
21.	中華醫學會感染病學分會艾滋病丙型肝炎學組, 中國疾病預防控制中心. 中國艾滋病診療指南(2021年版). 中國艾滋病性病, 2021, 27(11): 1182-1201.
22.	Hoen B, Bonnet F, Delaugerre C, et al. French 2013 guidelines for antiretroviral therapy of HIV-1 infection in adults. J Int AIDS Soc, 2014, 17(1): 19034.
23.	European AIDS Clinical Society. European AIDS Clinical Society Guidelines version 11.0. Available at: https://eacs.sanfordguide.com/.
24.	Manosuthi W, Ongwandee S, Bhakeecheep S, et al. Guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2014, Thailand. AIDS Res Ther, 2015, 12: 12.
25.	Grace JM, Semple SJ, Combrink S. Exercise therapy for human immunodeficiency virus/AIDS patients: guidelines for clinical exercise therapists. J Exerc Sci Fit, 2015, 13(1): 49-56.
26.	Saag MS, Gandhi RT, Hoy JF, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2020 recommendations of the International Antiviral Society-USA Panel. JAMA, 2020, 324(16): 1651-1669.
27.	World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. Available at: https://apps.who.int/iris/handle/10665/342899?search-result=true&query=Consolidated+Guidelines+on+HIV+Prevention%2C+Testing%2C+Treatment%2C+Service&scope=&rpp=10&sort_by=score&order=desc.

1. Joint United National Programme on HIV/AIDS. 2021-UNAIDS-data. Available at: https://www.unaids.org/en/resources/documents/2021/2021_unaids_data.
2. Joint United National Programme on HIV/AIDS. Global AIDS strategy 2021-2026. Available at: https://www.unaids.org/en/Global-AIDS-Strategy-2021-2026.
3. 黃超, 杜亮, 陳耀龍, 等. 中國醫務人員對臨床實踐指南的使用和需求調查. 中國循證醫學雜志, 2019, 19(6): 635-638.
4. Qaseem A, Forland F, Macbeth F, et al. Guidelines International Network: toward international standards for clinical practice guidelines. Ann Intern Med, 2012, 156(7): 525-531.
5. 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.
6. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-842.
7. Chen Y, Yang K, Maru?ic A, et al. A reporting tool for practice guidelines in health care: the RIGHT statement. Ann Intern Med, 2017, 166(2): 128-132.
8. 張雪芹, 鄧宏勇. 循證醫學數據庫: 現狀與趨勢. 中國循證醫學雜志, 2021, 21(6): 621-627.
9. 韋當, 王聰堯, 肖曉娟, 等. 指南研究與評價(AGREEⅡ)工具實例解讀. 中國循證兒科雜志, 2013, 8(4): 316-319.
10. Hoydonckx Y, Kumar P, Flamer D, et al. Quality of chronic pain interventional treatment guidelines from pain societies: assessment with the AGREE II instrument. Eur J Pain, 2020, 24(4): 704-721.
11. Rachlis AR, Zarowny DP, Canadian HIV Trials Network Antiretroviral Working Group. Guidelines for antiretroviral therapy for HIV infection. CMAJ. 1998. 158(4): 496-505.
12. Antinori A, Ammassari A, Torti C, et al. Italian consensus statement on management of HIV-infected individuals with advanced disease na?ve to antiretroviral therapy. Infection, 2009, 37(3): 270-282.
13. 鄭毓芳, 康來儀, 潘孝彰, 等. 人類免疫缺陷病毒感染特殊人群抗病毒治療方案共識. 內科理論與實踐, 2013, 8(2): 137-146.
14. 中華醫學會熱帶病與寄生蟲學分會艾滋病學組. 人類免疫缺陷病毒/艾滋病抗病毒治療換藥策略專家共識. 中華傳染病雜志, 2019, (7): 397-402.
15. 中華中醫藥學會防治艾滋病分會. 艾滋病并發周圍神經病變中西醫協同治療專家共識. 中醫學報, 2020, 35(6): 1212-1214.
16. 王輝, 李在村, 趙紅心, 等. 人類免疫缺陷病毒(HIV)抗病毒治療二聯簡化療法專家共識. 中國艾滋病性病, 2020, 26(3): 331-334, 336.
17. 中國性病艾滋病防治協會學術委員會外科學組, 中華醫學會熱帶病與寄生蟲學分會外科學組. 中國人類免疫缺陷病毒感染者圍手術期抗病毒治療專家共識. 中華實驗和臨床感染病雜志(電子版), 2019, 13(1): 1-5.
18. Centers for Disease Control and Prevention. Report of the NIH panel to define principles of therapy of HIV infection and guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. MMWR, 1998, 47(RR-5): 43-82.
19. AIDS Society of India. API consensus guidelines for use of antiretroviral therapy in adults (API-ART guidelines). J Assoc Physicians India, 2006, 54: 57-74.
20. 中華中醫藥學會防治艾滋病分會. 艾滋病中醫診療指南(2013版). 中醫學報, 2014, 29(5): 617-620.
21. 中華醫學會感染病學分會艾滋病丙型肝炎學組, 中國疾病預防控制中心. 中國艾滋病診療指南(2021年版). 中國艾滋病性病, 2021, 27(11): 1182-1201.
22. Hoen B, Bonnet F, Delaugerre C, et al. French 2013 guidelines for antiretroviral therapy of HIV-1 infection in adults. J Int AIDS Soc, 2014, 17(1): 19034.
23. European AIDS Clinical Society. European AIDS Clinical Society Guidelines version 11.0. Available at: https://eacs.sanfordguide.com/.
24. Manosuthi W, Ongwandee S, Bhakeecheep S, et al. Guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2014, Thailand. AIDS Res Ther, 2015, 12: 12.
25. Grace JM, Semple SJ, Combrink S. Exercise therapy for human immunodeficiency virus/AIDS patients: guidelines for clinical exercise therapists. J Exerc Sci Fit, 2015, 13(1): 49-56.
26. Saag MS, Gandhi RT, Hoy JF, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2020 recommendations of the International Antiviral Society-USA Panel. JAMA, 2020, 324(16): 1651-1669.
27. World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. Available at: https://apps.who.int/iris/handle/10665/342899?search-result=true&query=Consolidated+Guidelines+on+HIV+Prevention%2C+Testing%2C+Treatment%2C+Service&scope=&rpp=10&sort_by=score&order=desc.

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