Quality of Evidence-Based Guidelines for Transfusion of Red Blood Cells and Plasma: A Systematic Review

被引：26

作者：

Pavenski, Katerina ^{[1
]}

Stanworth, Simon ^{[2
,3
,4
]}

Fung, Mark ^{[5
,6
]}

Wood, Erica M. ^{[7
,8
]}

Pink, Joanne ^{[9
]}

Murphy, Michael F. ^{[2
,3
,4
]}

Hume, Heather ^{[10
]}

Nahirniak, Susan ^{[11
]}

Webert, Kathryn E. ^{[12
,13
]}

Tanael, Susano ^{[14
]}

Landry, Denise ^{[15
]}

Shehata, Nadine ^{[14
,16
,17
,18
]}

机构：

[1] St Michaels Hosp, Dept Lab Med & Pathobiol, Toronto, ON, Canada

[2] Oxford Univ Hosp, Biomed Res Ctr, Natl Hlth Serv NHS Blood & Transplant, Oxford, England

[3] Oxford Univ Hosp, Biomed Res Ctr, Oxford Natl Inst Hlth Res NIHR, Oxford, England

[4] Univ Oxford, Oxford, England

[5] Univ Vermont Hlth Network, Burlington, VT USA

[6] Univ Vermont, Burlington, VT USA

[7] Monash Univ, Transfus Res Unit, Melbourne, Vic, Australia

[8] Monash Hlth, Dept Clin Haematol, Melbourne, Vic, Australia

[9] Australian Red Cross Blood Serv, Kelvin Grove, Qld, Australia

[10] Univ Montreal, Montreal, PQ, Canada

[11] Univ Alberta, Edmonton, AB, Canada

[12] McMaster Univ, Ancaster, ON, Canada

[13] Canadian Blood Serv, Ancaster, ON, Canada

[14] Canadian Blood Serv, Toronto, ON, Canada

[15] Canadian Blood Serv, Ottawa, ON, Canada

[16] Mt Sinai Hosp, Inst Hlth Policy Management & Evaluat, Dept Med, Toronto, ON, Canada

[17] Mt Sinai Hosp, Inst Hlth Policy Management & Evaluat, Dept Lab Med, Toronto, ON, Canada

[18] Mt Sinai Hosp, Inst Hlth Policy Management & Evaluat, Dept Pathobiol, Toronto, ON, Canada

来源：

TRANSFUSION MEDICINE REVIEWS | 2018年 / 32卷 / 03期

关键词：

Quality; Guidelines; Rbc; Plasma; AGREE II; CLINICAL-PRACTICE GUIDELINES; AGREE II; MANAGEMENT; DISEASE; ALTERNATIVES; LIMITATIONS; ANEMIA; TOOLS;

D O I：

10.1016/j.tmrv.2018.05.004

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Many transfusion guidelines are available, but little appraisal of their quality has been undertaken. The quality of guidelines may potentially influence adoption. Our aim was to determine the quality of evidence-based transfusion guidelines (EBG) for red cells and plasma, using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and assess duplication and consistency of recommendations. MEDLINE and EMBASE were systematically searched for EBG from 2005 to June 3,2016. Citations were reviewed for inclusion in duplicate. A guideline was included if it had a specified clinical question, described a systematic search strategy, included critical appraisal of the literature and a description of how recommendations were developed. Four to six physicians used AGREE II to appraise each guideline. Median and scaled scores were calculated, with each item scored on a scale of one to seven, seven representing the highest score. Of 6174 citations, 30 guidelines met inclusion criteria. Twenty six guidelines had recommendations for red cells and 18 included recommendations for plasma use. The median score, the scaled score and the interquartile range of the scaled score were: scope and purpose: median score 5, scaled score 60%, IQR (49-74%); stakeholder involvement 4, 43%, (3349%); rigor of development 4, 41%, (19-59%); clarity of presentation 5, 69%, (52-81%); applicability 1, 16%, (923%); editorial independence 3, 43%, (20-58%). Sixteen guidelines were evaluated to have a scaled domain score of 50% or less. Variations in recommendations were found for the use of hemoglobin triggers for red cell transfusion in patients with acute coronary syndromes and for plasma use for patients with bleeding. Our findings document, limited rigor in guideline development and duplication and inconsistencies in recommendations for the same topic. The process of developing guidelines for red cells and plasma transfusion can be enhanced to improve implementation. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：135 / 143

页数：9

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