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首页> 外文期刊>BMC Family Practice >Guidelines on acute gastroenteritis in children: a critical appraisal of their quality and applicability in primary care
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Guidelines on acute gastroenteritis in children: a critical appraisal of their quality and applicability in primary care

机译：儿童急性肠胃炎指南：对其质量和在初级保健中的适用性的严格评估

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Background Reasons for poor guideline adherence in acute gastroenteritis (AGE) in children in high-income countries are unclear, but may be due to inconsistency between guideline recommendations, lack of evidence, and lack of generalizability of the recommendations to general practice. The aim of this study was to assess the quality of international guidelines on AGE in children and investigate the generalizability of the recommendations to general practice. Methods Guidelines were retrieved from websites of professional medical organisations and websites of institutes involved in guideline development. In addition, a systematic search of the literature was performed. Articles were selected if they were a guideline, consensus statement or care protocol. Results Eight guidelines met the inclusion criteria, the quality of the guidelines varied. 242 recommendations on diagnosis and management were found, of which 138 (57%) were based on evidence. There is a large variety in the classification of symptoms to different categories of dehydration. No signs are generalizable to general practice. It is consistently recommended to use hypo-osmolar ORS, however, the recommendations on ORS-dosage are not evidence based and are inconsistent. One of 14 evidence based recommendations on therapy of AGE is based on outpatient research and is therefore generalizable to general practice. Conclusions The present study shows considerable variation in the quality of guidelines on AGE in children, as well as inconsistencies between the recommendations. It remains unclear how to asses the extent of dehydration and determine the preferred treatment or referral of a young child with AGE presenting in general practice.
机译：背景目前尚不清楚高收入国家儿童急性胃肠炎（AGE）指南依从性差的原因，但这可能是由于指南建议之间不一致，证据不足以及建议对一般实践的可概括性不足所致。这项研究的目的是评估有关儿童AGE的国际准则的质量，并研究建议对一般实践的普遍性。方法从专业医疗机构的网站和参与指南制定的机构的网站中检索指南。另外，对文献进行了系统的搜索。如果文章是指南，共识声明或护理协议，则选择它们。结果八项指南符合纳入标准，指南的质量各不相同。找到了242条有关诊断和治疗的建议，其中138条（占57％）是基于证据的。对于不同类别的脱水，症状的分类有很多。没有迹象可推广到一般实践。始终建议使用低渗性ORS，但是，关于ORS剂量的建议不是基于证据的，并且不一致。关于AGE治疗的14个循证医学建议之一是基于门诊研究，因此可以推广到一般实践。结论本研究表明，儿童AGE指南的质量存在很大差异，并且建议之间存在不一致之处。目前尚不清楚如何评估脱水程度并确定一般实践中出现AGE的幼儿的首选治疗或转诊。

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