Xiaoling Duan

Summary Objective This study aims to evaluate the quality of clinical practice guidelines for diagnosing and treating allergic rhinitis and analyse the heterogeneity of recommendations and supporting evidence among these guidelines. Method A systematic search was conducted to identify clinical guidelines related to allergic rhinitis. Evaluators use the AGREE II instrument to assess the quality of the included guidelines. The Consistency Measurement Scale (MSRA) was applied to evaluate the scientific consistency of diagnostic and treatment recommendations, and the evidence supporting these recommendations was extracted and analysed. Results Twelve guidelines for diagnosing and treating allergic rhinitis were ultimately included. After further review and analysis, 7 clinical guidelines with an overall score of more than 60% were recommended. Heterogeneity was observed in the recommendations and supporting evidence across different guidelines. Contributing factors included contradictions between recommendations on traditional Chinese medicine, acupuncture, and moxibustion treatment, the regional specificity of these treatments, and the inappropriate citation of surgical treatment evidence. Conclusion This study revealed significant differences in the levels of evidence in the same field across different guidelines. Even within individual guidelines, inconsistencies in recommendations across different areas were identified. Further analysis to determine the underlying causes and efforts to rectify existing issues may help improve the quality of clinical guidelines for diagnosing and treating allergic rhinitis.

The aim of this study was to systematically assess the quality of different guidelines for the management of patients with hyperthyroidism and to explore and analyze the recommendations and key evidence in different guidelines. A systematic search of databases and websites was conducted to identify treatment guidelines for hyperthyroidism. The quality of the included guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. To evaluate the level of agreement among the guidelines, we employed the Measurement Scale of Rate of Agreement (MSRA), extracting and analyzing the evidence supporting these recommendations. Eleven guidelines for the management of patients with hyperthyroidism were identified. The guidelines from the American Thyroid Association (ATA), the Japanese Thyroid Association (JTA), the European Thyroid Association (ETA, 2022) and the Chinese Medical Association (CMA) had overall quality scores greater than 60% and warranted clinical recommendation. Recommendations vary widely across guidelines, and the main reasons included different emphases on the diagnosis of hyperthyroidism, different target populations, irrational selection of evidence and geographic variation. The quality of hyperthyroidism treatment guidelines is variable, and treatment recommendations vary greatly from guideline between guidelines. Analyzing and improving the causes of inconsistencies in recommendations for patients with hyperthyroidism could be a reasonable and effective way for developers to improve the quality of guidelines for the management of hyperthyroidism.