Clinical practice guidelines of bronchoalveolar lavage: a methodological quality study_Chinese Journal of Evidence-Based Medicine

Authors：

LI Wanyi ^1,2 , WANG Yongjun ^1,2 , WEI Lili ^3,4,5 , YANG Liu ^1,2,6 , WANG Wenyuan ^1,2 , ZHANG Ruipeng ^1,2,7 , DU Weiping ⁸ , YANG Kehu ^2,3,4,5 ,  LIU Donghai ^1,2 , YI Bin ^1,2

1. Department of Pediatric Respiratory Medicine, Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730050, P.R.China;
2. Pediatric Clinical Medicine Research Center of Gansu Province, Lanzhou 730050, P.R.China;
3. Evidence-based Medicine Center of Lanzhou University, Lanzhou 730000, P.R.China;
4. Key Laboratory of Evidence-based Medicine and Clinical Transformation of Gansu Province, Lanzhou 730000, P.R.China;
5. Industry Technology Centre for Medical Guideline of Gansu Province, Lanzhou 730000, P.R.China;
6. School of Nursing, Lanzhou University, Lanzhou 730000, P.R.China;
7. School of Nursing, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, P.R.China;
8. Wuwei People’s Hospital, Wuwei 733000, P.R.China;

Corresponding?author：

LIU Donghai, Email: ldhai2005@163.com

Keywords：

Bronchoscope; Lung lavage; Guideline; Quality assessment; AGREE Ⅱ

DOI：

10.7507/1672-2531.202108085

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To assess the methodological quality of guidelines for bronchoscopic alveolar lavage. Methods CNKI, VIP, WanFang Data, CBM, Web of Science, PubMed, EMbase databases and medlive.cn, the National Guideline Clearinghouse (NGC), the National Guideline International Network (GIN), the Scottish Intercollegiate Guidelines Network (SIGN), the National Institute for Clinical Excellence (NICE), and the World Health Organization (WHO) websites were electronically searched to collect guidelines of bronchoscopic alveolar lavage from inception to December 2020. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of the guidelines by using AGREE Ⅱ tool. Results A total of 19 guidelines were included, with 5 from China, 5 from the USA, 3 from Europe, 2 from the UK, 1 from Australia, 1 from Israel, 1 from Spain, and 1 from India. The average standard score rates of the 19 guidelines in the six fields were 50.73% for scope and purpose, 20.02% for participants, 15.13% for formulation rigor, 36.40% for clarity of presentation, 3.51% for applicability, and 22.37% for editorial independence.Conclusions The quality of bronchoalveolar lavage guidelines remains relatively low.

Citation： LI Wanyi, WANG Yongjun, WEI Lili, YANG Liu, WANG Wenyuan, ZHANG Ruipeng, DU Weiping, YANG Kehu, LIU Donghai, YI Bin. Clinical practice guidelines of bronchoalveolar lavage: a methodological quality study. Chinese Journal of Evidence-Based Medicine, 2021, 21(11): 1325-1331. doi: 10.7507/1672-2531.202108085 Copy

1.	中華醫學會呼吸病學分會. 肺部感染性疾病支氣管肺泡灌洗病原體檢測中國專家共識(2017年版). 中華結核和呼吸雜志, 2017, 40(8): 578-583.
2.	Hautmann H, Hetzel J, Eberhardt R, et al. Cross-sectional survey on bronchoscopy in germany-the current status of clinical practice. Pneumologie, 2016, 70(2): 110-116.
3.	AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care, 2003, 12(1): 18-23.
4.	Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
5.	Brouwers MC, Kho ME, Browman GP, et al. The global rating scale complements the AGREE Ⅱ in advancing the quality of practice guidelines. J Clin Epidemiol, 2012, 65(5): 526-534.
6.	韋當, 王聰堯, 肖曉娟, 等. 指南研究與評價(AGREE Ⅱ)工具實例解讀. 中國循證兒科雜志, 2013, 8(4): 316-319.
7.	Sorli J. Guidelines for bronchoscopy with the fiberoptic bronchoscope in adults. Plucne Bolesti, 1988, 40(1-2): 85-87.
8.	Costabel U, Danel C, Haslam P, et al. Technical recommendations and guidelines for bronchoalveolar lavage (BAL). Report of the European society of pneumology task group. Eur Respir J, 1989, 2(6): 561-585.
9.	de Blic J, Midulla F, Barbato A, et al. Bronchoalveolar lavage in children. ERS Task Force on bronchoalveolar lavage in children. European Respiratory Society. Eur Respir J, 2000, 15(1): 217-231.
10.	Wood-Baker R, Burdon J, McGregor A, et al. Fibre-optic bronchoscopy in adults: a position paper of the thoracic society of Australia and New Zealand. Intern Med J, 2001, 31(8): 479-487.
11.	Clifton S. AARC clinical practice guideline - bronchoscopy assisting - 2007 revision & update. Resp Care, 2007, 52(1): 74-80.
12.	Hoffman AM. Bronchoalveolar lavage: sampling technique and guidelines for cytologic preparation and interpretation. Vet Clin North Am Equine Pract, 2008, 24(2): 423-435.
13.	Shulimzon TR,. Flexible bronchoscopy in Israel 2010: evidence-based clinical practice guidelines for the adult patient. A concise summary of the recommendations of the Israel Lung Association Task Force. Isr Med Assoc J, 2010, 12(2): 69-73.
14.	Pérez-Frías J, Moreno Galdó A, Pérez Ruiz E, et al. Pediatric bronchoscopy guidelines. Arch Bronconeumol, 2011, 47(7): 350-360.
15.	Du Rand IA, Barber PV, Goldring J, et al. British thoracic society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax, 2011, 66(Suppl 3): iii1-21.
16.	Meyer KC, Raghu G, Baughman RP, et al. An official American thoracic society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med, 2012, 185(9): 1004-1014.
17.	Du Rand IA, Blaikley J, Booton R, et al. British thoracic society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax, 2013, 68(Suppl 1): i1-i44.
18.	Faro A, Wood RE, Schechter MS, et al. Official American thoracic society technical standards: flexible airway endoscopy in children. Am J Respir Crit Care Med, 2015, 191(9): 1066-1080.
19.	Eber E, Antón-Pacheco JL, de Blic J, et al. ERS statement: interventional bronchoscopy in children. Eur Respir J, 2017, 50(6): 1700901.
20.	Mohan A, Madan K, Hadda V, et al. Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations. Lung India, 2019, 36(Supplement): S37-S89.
21.	中華醫學會呼吸病學分會介入呼吸病學學組. 成人診斷性可彎曲支氣管鏡檢查術應用指南(2019年版). 中華結核和呼吸雜志, 2019, (8): 573-590.
22.	《中華兒科雜志》編輯委員會中華醫學會兒科學分會新生兒學組. 新生兒黃疸診療原則的專家共識. 中華兒科雜志, 2010, 48(9): 685-686.
23.	國家衛生健康委員會人才交流服務中心兒科呼吸內鏡診療技術專家組, 中國醫師協會兒科醫師分會內鏡專業委員會, 中國醫師協會內鏡醫師分會兒科呼吸內鏡專業委員會, 等. 中國兒科可彎曲支氣管鏡術指南(2018年版). 中華實用兒科臨床雜志, 2018, 33(13): 983-989.
24.	國家衛生健康委員會人才交流服務中心兒科呼吸內鏡診療技術項目專家組, 中國醫師協會兒科醫師分會內鏡專業委員會, 中國醫師協會內鏡醫師分會兒科呼吸內鏡專業委員會, 等. 中國兒童難治性肺炎呼吸內鏡介入診療專家共識. 中國實用兒科雜志, 2019, 34(6): 449-457.
25.	李秀霞, 韓雪梅, 楊克虎. 循證衛生政策的發展與展望. 圖書與情報, 2018, (3): 43-49.
26.	楊克虎. 循證社會科學的產生、發展與未來. 圖書與情報, 2018, (3): 1-10.
27.	楊克虎, 李秀霞, 拜爭剛. 循證社會科學研究方法: 系統評價與Meta分析. 蘭州: 蘭州大學出版社, 2018.
28.	Medicine IO, Graham R, Mancher M, et al. Clinical practice guidelines we can trust. Washington DC: National Academies Press, 2011.
29.	Bello S, Ajayi DT, Bamgboye EA, et al. Is evidence-based medicine a mirage in resource-constrained settings. A survey among resident doctors in selected teaching hospitals in Nigeria. J Evid Based Med, 2020, 13(1): 17-24.
30.	Puljak L. Evidence synthesis and methodological research on evidence in medicine-Why it really is research and it really is medicine. J Evid Based Med, 2020, 13(4): 253-254.
31.	Yao X, Florez ID, Zhang P, et al. Clinical research methods for treatment, diagnosis, prognosis, etiology, screening, and prevention: A narrative review. J Evid Based Med, 2020, 13(2): 130-136.
32.	Hoffmann-E?er W, Siering U, Neugebauer EAM, et al. Guideline appraisal with AGREE Ⅱ: online survey of the potential influence of AGREE Ⅱ items on overall assessment of guideline quality and recommendation for use. BMC Health Serv Res, 2018, 18(1): 143.
33.	王吉耀, 王小欽, 金雪娟, 等. 中國臨床實踐指南評價體系的制訂與初步驗證. 中華醫學雜志, 2018, 98(20): 1544-1548.
34.	李幼平, 李靜, 孫鑫, 等. 循證醫學在中國的起源與發展: 獻給中國循證醫學20周年. 中國循證醫學雜志, 2016, 16(1): 2-6.

1. 中華醫學會呼吸病學分會. 肺部感染性疾病支氣管肺泡灌洗病原體檢測中國專家共識(2017年版). 中華結核和呼吸雜志, 2017, 40(8): 578-583.
2. Hautmann H, Hetzel J, Eberhardt R, et al. Cross-sectional survey on bronchoscopy in germany-the current status of clinical practice. Pneumologie, 2016, 70(2): 110-116.
3. AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care, 2003, 12(1): 18-23.
4. Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
5. Brouwers MC, Kho ME, Browman GP, et al. The global rating scale complements the AGREE Ⅱ in advancing the quality of practice guidelines. J Clin Epidemiol, 2012, 65(5): 526-534.
6. 韋當, 王聰堯, 肖曉娟, 等. 指南研究與評價(AGREE Ⅱ)工具實例解讀. 中國循證兒科雜志, 2013, 8(4): 316-319.
7. Sorli J. Guidelines for bronchoscopy with the fiberoptic bronchoscope in adults. Plucne Bolesti, 1988, 40(1-2): 85-87.
8. Costabel U, Danel C, Haslam P, et al. Technical recommendations and guidelines for bronchoalveolar lavage (BAL). Report of the European society of pneumology task group. Eur Respir J, 1989, 2(6): 561-585.
9. de Blic J, Midulla F, Barbato A, et al. Bronchoalveolar lavage in children. ERS Task Force on bronchoalveolar lavage in children. European Respiratory Society. Eur Respir J, 2000, 15(1): 217-231.
10. Wood-Baker R, Burdon J, McGregor A, et al. Fibre-optic bronchoscopy in adults: a position paper of the thoracic society of Australia and New Zealand. Intern Med J, 2001, 31(8): 479-487.
11. Clifton S. AARC clinical practice guideline - bronchoscopy assisting - 2007 revision & update. Resp Care, 2007, 52(1): 74-80.
12. Hoffman AM. Bronchoalveolar lavage: sampling technique and guidelines for cytologic preparation and interpretation. Vet Clin North Am Equine Pract, 2008, 24(2): 423-435.
13. Shulimzon TR,. Flexible bronchoscopy in Israel 2010: evidence-based clinical practice guidelines for the adult patient. A concise summary of the recommendations of the Israel Lung Association Task Force. Isr Med Assoc J, 2010, 12(2): 69-73.
14. Pérez-Frías J, Moreno Galdó A, Pérez Ruiz E, et al. Pediatric bronchoscopy guidelines. Arch Bronconeumol, 2011, 47(7): 350-360.
15. Du Rand IA, Barber PV, Goldring J, et al. British thoracic society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax, 2011, 66(Suppl 3): iii1-21.
16. Meyer KC, Raghu G, Baughman RP, et al. An official American thoracic society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med, 2012, 185(9): 1004-1014.
17. Du Rand IA, Blaikley J, Booton R, et al. British thoracic society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax, 2013, 68(Suppl 1): i1-i44.
18. Faro A, Wood RE, Schechter MS, et al. Official American thoracic society technical standards: flexible airway endoscopy in children. Am J Respir Crit Care Med, 2015, 191(9): 1066-1080.
19. Eber E, Antón-Pacheco JL, de Blic J, et al. ERS statement: interventional bronchoscopy in children. Eur Respir J, 2017, 50(6): 1700901.
20. Mohan A, Madan K, Hadda V, et al. Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations. Lung India, 2019, 36(Supplement): S37-S89.
21. 中華醫學會呼吸病學分會介入呼吸病學學組. 成人診斷性可彎曲支氣管鏡檢查術應用指南(2019年版). 中華結核和呼吸雜志, 2019, (8): 573-590.
22. 《中華兒科雜志》編輯委員會中華醫學會兒科學分會新生兒學組. 新生兒黃疸診療原則的專家共識. 中華兒科雜志, 2010, 48(9): 685-686.
23. 國家衛生健康委員會人才交流服務中心兒科呼吸內鏡診療技術專家組, 中國醫師協會兒科醫師分會內鏡專業委員會, 中國醫師協會內鏡醫師分會兒科呼吸內鏡專業委員會, 等. 中國兒科可彎曲支氣管鏡術指南(2018年版). 中華實用兒科臨床雜志, 2018, 33(13): 983-989.
24. 國家衛生健康委員會人才交流服務中心兒科呼吸內鏡診療技術項目專家組, 中國醫師協會兒科醫師分會內鏡專業委員會, 中國醫師協會內鏡醫師分會兒科呼吸內鏡專業委員會, 等. 中國兒童難治性肺炎呼吸內鏡介入診療專家共識. 中國實用兒科雜志, 2019, 34(6): 449-457.
25. 李秀霞, 韓雪梅, 楊克虎. 循證衛生政策的發展與展望. 圖書與情報, 2018, (3): 43-49.
26. 楊克虎. 循證社會科學的產生、發展與未來. 圖書與情報, 2018, (3): 1-10.
27. 楊克虎, 李秀霞, 拜爭剛. 循證社會科學研究方法: 系統評價與Meta分析. 蘭州: 蘭州大學出版社, 2018.
28. Medicine IO, Graham R, Mancher M, et al. Clinical practice guidelines we can trust. Washington DC: National Academies Press, 2011.
29. Bello S, Ajayi DT, Bamgboye EA, et al. Is evidence-based medicine a mirage in resource-constrained settings. A survey among resident doctors in selected teaching hospitals in Nigeria. J Evid Based Med, 2020, 13(1): 17-24.
30. Puljak L. Evidence synthesis and methodological research on evidence in medicine-Why it really is research and it really is medicine. J Evid Based Med, 2020, 13(4): 253-254.
31. Yao X, Florez ID, Zhang P, et al. Clinical research methods for treatment, diagnosis, prognosis, etiology, screening, and prevention: A narrative review. J Evid Based Med, 2020, 13(2): 130-136.
32. Hoffmann-E?er W, Siering U, Neugebauer EAM, et al. Guideline appraisal with AGREE Ⅱ: online survey of the potential influence of AGREE Ⅱ items on overall assessment of guideline quality and recommendation for use. BMC Health Serv Res, 2018, 18(1): 143.
33. 王吉耀, 王小欽, 金雪娟, 等. 中國臨床實踐指南評價體系的制訂與初步驗證. 中華醫學雜志, 2018, 98(20): 1544-1548.
34. 李幼平, 李靜, 孫鑫, 等. 循證醫學在中國的起源與發展: 獻給中國循證醫學20周年. 中國循證醫學雜志, 2016, 16(1): 2-6.

Chinese Journal of Evidence-Based Medicine

Clinical practice guidelines of bronchoalveolar lavage: a methodological quality study

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