文献类型：期刊文献

英文题名：How consistent are the key recommendations, and what is the quality of guidelines and expert consensus regarding paediatric cow's milk protein allergy?

作者：Li, Tengfei[1,2];Zheng, Qingyong[2];Zhang, Mingyue[2];Li, Yiyi[1];Zhou, Yongjia[1];Xu, Caihua[2];Zhang, Bowa[1];Wang, Zewei[3];Tian, Jinhui[2];Zhou, Li[4]

第一作者：Li, Tengfei

通信作者：Tian, JH[1];Zhou, L[2]

机构：[1]Gansu Univ Chinese Med, Sch Nursing, Lanzhou, Peoples R China;[2]Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China;[3]Lanzhou Univ, Clin Coll Med 1, Lanzhou, Peoples R China;[4]Gansu Prov Matern & Child Hlth Hosp, Gansu Prov Cent Hosp, Dept Gastroenterol, Lanzhou, Peoples R China

第一机构：甘肃中医药大学护理学院

通信机构：[1]corresponding author), Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China;[2]corresponding author), Gansu Prov Matern & Child Hlth Hosp, Gansu Prov Cent Hosp, Dept Gastroenterol, Lanzhou, Peoples R China.

年份：2024

卷号：183

期号：8

起止页码：3543

外文期刊名：EUROPEAN JOURNAL OF PEDIATRICS

收录：;Scopus(收录号：2-s2.0-85194741210);WOS:【SCI-EXPANDED(收录号:WOS:001234557100001)】；

基金：We extend our deepest gratitude to the dedicated individuals who developed the guidelines, the insightful reviewers for their invaluable feedback, our research team for their unwavering support and collaboration throughout this study, and express our sincere appreciation for the support provided by the Natural Science Foundation of Gansu Province. This work was supported by the Natural Science Foundation of Gansu Province (21JR11RA178).

语种：英文

外文关键词：AGREE II; AGREE-REX; Cow's milk protein allergy; Guidelines; Expert consensus; Quality assessment

摘要：The objective of this study was to assess the quality and consistency of recommendations in clinical practice guidelines (CPGs) and expert consensus on paediatric cow's milk protein allergy (CMPA) to serve as a foundation for future revisions and enhancements of clinical guidelines and consensus documents. We conducted a comprehensive literature search across several databases, including the Chinese Biomedical Literature Database (CBM), PubMed, Embase, Web of Science, UpToDate, ClinicalKey, DynaMed Plus and BMJ Best Practice. We spanned the search period from the inception of each database through October 1, 2023. We integrated subject headings (MeSH/Emtree) and keywords into the search strategy, used the search methodologies of existing literature and developed it in collaboration with a librarian. Two trained researchers independently conducted the literature screening and data extraction. We evaluated methodological quality and recommendations by using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and AGREE-Recommendations for Excellence (AGREE-REX) tools. Moreover, we compared and summarized key recommendations from high-quality CPGs. Our study included 27 CPGs and expert consensus documents on CMPA. Only four CPGs (14.8%) achieved a high-quality AGREE II rating. The four high-quality CPGs consistently provided recommendations for CMPA. The highest scoring domains for AGREE II were 'scope and purpose' (77 +/- 12%) and 'clarity of presentation' (75 +/- 22%). The lowest scoring domains were 'stakeholder involvement' (49 +/- 21%), 'rigor of development' (34 +/- 20%) and 'applicability' (12 +/- 20%). Evaluation with AGREE-REX generally demonstrated low scores across its domains. Conclusion: Recommendations within high-quality CPGs for the paediatric CMPA showed fundamental consistency. Nevertheless, the methodology and recommendation content of CPGs and the expert consensus exhibited low quality, thus indicating a substantial scope for enhancement. Guideline developers should rigorously follow the AGREE II and AGREE-REX standards in creating CPGs or expert consensuses to guarantee their clinical efficacy in managing paediatric CMPA. What is Known:center dot The quality of clinical practice guidelines and expert consensus on paediatric cow's milk protein allergy (CMPA) remains uncertain.center dot There is a lack of clarity regarding the consistency of crucial recommendations for CMPA management.What is New:center dot Improving the methodological quality of guidelines and consensus on CMPA requires greater emphasis on stakeholder engagement, rigorous development processes, and practical applicability.center dot The recommendations from four high-quality guidelines align. However, addressing clinical applicability, integrating values and preferences, and ensuring actionable implementation are critical to improving the quality of all guidelines.