Purpose

Several clinical practice guidelines (CPGs) have been produced to optimize the diagnosis and management of pediatric foreign body aspiration and ingestion. However, to date there have been no critical evaluations of their methodological rigor or quality. Herein, we address this need via the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.

Methods

A literature search of Embase, MEDLINE via PubMed, and Scopus was performed up until February 25, 2021. Identified CPGs were then assessed by four independent reviewers trained in AGREE II. A scaled domain score of >60% was indicated as satisfactory quality. Intraclass correlation coefficients (ICC) were calculated to assess inter-reviewer agreement.

Results

11 guidelines were assessed with only one being classified as high quality and others being either average (two) or low quality (eight). Domain 4 (clarity of presentation) achieved the highest mean score (66.41 ± 13.33%), while domain 5 (applicability) achieved the lowest score (10.80 ± 10.37%). ICC analysis revealed generally strong agreement between reviewers with a range of 0.60–0.98.

Conclusion

Quality appraisal using the AGREE II instrument suggests that the methodologic rigor and quality of current guidelines for the diagnosis and management of pediatric foreign body aspiration and ingestion need significant improvement.

中文翻译：

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儿科异物吸入和摄入管理的临床实践指南：使用 AGREE II 仪器进行系统评估

目的

已经制定了一些临床实践指南（CPG）来优化儿科异物吸入和摄入的诊断和管理。然而，迄今为止，还没有对其方法的严谨性或质量进行严格的评估。在此，我们通过研究和评估指南评估 (AGREE II) 工具来满足这一需求。

方法

截至 2021 年 2 月 25 日，对 Embase、通过 PubMed 的 MEDLINE 和 Scopus 进行了文献检索。然后由四名经过 AGREE II 培训的独立评审员对确定的 CPG 进行评估。>60% 的缩放域分数表示质量令人满意。计算组内相关系数（ICC）以评估审稿人之间的一致性。

结果

对 11 项指南进行了评估，其中只有一项被评为高质量，其他则为一般（2 项）或低质量（8 项）。领域 4（演示清晰度）获得最高平均得分（66.41 ± 13.33%），而领域 5（适用性）获得最低得分（10.80 ± 10.37%）。ICC 分析显示，评审者之间普遍存在很强的一致性，范围为 0.60-0.98。

结论

使用 AGREE II 仪器进行的质量评估表明，现行儿童异物吸入和摄入诊断和管理指南的方法严谨性和质量需要显着提高。