An Evaluation Of Guidelines For Fractures In Children Quality Base-on Appraisal Of Guidelines For Research And Evaluation Tools

Objective:To understand the status of guidelines for children's fractures in the last 10 years,and to use the Appraisal of Guidelines for Research and Evaluation(AGREE II)tool to evaluate the quality of children's fracture guidelines included,to provide references for clinical practice and evidence-based guidelines of children's fractures.Methods: 1.We searched CNKI,VIP,CBM,wanfang,Pubmed,Embase,Web of science and Cochrane databases,and manually searched websites such as meimaitong,NICE,NGC,SIGN,WHO,etc.,to search fracture guidelines for children in the past nearly 10 years.2.Extract the basic features of the inclusion guideline,and use the AGREE II tool to evaluate the quality of the inclusion guideline,and comprehensively judge the recommendation level of the guideline based on the scores in the AGREE II field.Results:1.Ten guidelines were included,mainly involving the prophylactic use of antibiotics for open fractures,the treatment of pelvic fractures,the treatment of supracondylar fractures of the humerus,bone examination in children with fractures,the treatment of femoral shaft fractures in children,the treatment of open tibial fractures,the evaluation and management of complex and uncomplicated fractures,and so on.Mainly published from 2011 to 2016,including 7 guidelines in the us and 3 in the UK;Seven guidelines were non-evidence-based,three were non-evidence-based,five were aimed at children with fractures,and five were aimed at children and adults.2.Based on AGREE II evaluation of the quality of the 10 included guidelines,the results showed that the guidelines received the highest scores for scope and purpose(79.5%),followed by clarity(78.3%),and low scores for application(41.9%),rigor(40.4%),participants(39.4%),and editorial independence(38.3%).Among the 10 children's fracture-related clinical guidelines included,2 guidelines had scores of> 50% in six areas,which is highly recommended,and 4 guidelines had scores of> 30 in three areas,and scores of <50% in some areas.Weak recommendation;4 guidelines ? 3 areas,score <30%, not recommended.Conclusions: 1.The number of clinical guidelines related to fractures in children is small and the quality is uneven.Based on the evaluation results of AGREE II,the overall quality of the 10 guidelines included is general,2 guidelines are strongly recommended,4guidelines are weakly recommended,and 4 guidelines are not.recommend.2.Our country guidelines for children fractures should be developed as soon as possible according to the six areas of the Guidelines for Research and Evaluation II(AGREE II)tool,China should formulate guidelines for children's fracture that are suitable for China's national conditions,and standardize the diagnosis and treatment of children's fracture.