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.	中华医学会呼吸病学分会. 肺部感染性疾病支气管肺泡灌洗病原体检测中国专家共识(2017年版). 中华结核和呼吸杂志, 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.	韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREE Ⅱ)工具实例解读. 中国循证儿科杂志, 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.	中华医学会呼吸病学分会介入呼吸病学学组. 成人诊断性可弯曲支气管镜检查术应用指南(2019年版). 中华结核和呼吸杂志, 2019, (8): 573-590.
22.	《中华儿科杂志》编辑委员会中华医学会儿科学分会新生儿学组. 新生儿黄疸诊疗原则的专家共识. 中华儿科杂志, 2010, 48(9): 685-686.
23.	国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术专家组, 中国医师协会儿科医师分会内镜专业委员会, 中国医师协会内镜医师分会儿科呼吸内镜专业委员会, 等. 中国儿科可弯曲支气管镜术指南(2018年版). 中华实用儿科临床杂志, 2018, 33(13): 983-989.
24.	国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术项目专家组, 中国医师协会儿科医师分会内镜专业委员会, 中国医师协会内镜医师分会儿科呼吸内镜专业委员会, 等. 中国儿童难治性肺炎呼吸内镜介入诊疗专家共识. 中国实用儿科杂志, 2019, 34(6): 449-457.
25.	李秀霞, 韩雪梅, 杨克虎. 循证卫生政策的发展与展望. 图书与情报, 2018, (3): 43-49.
26.	杨克虎. 循证社会科学的产生、发展与未来. 图书与情报, 2018, (3): 1-10.
27.	杨克虎, 李秀霞, 拜争刚. 循证社会科学研究方法: 系统评价与Meta分析. 兰州: 兰州大学出版社, 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-Eßer 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, 王小钦, 金雪娟, 等. 中国临床实践指南评价体系的制订与初步验证. 中华医学杂志, 2018, 98(20): 1544-1548.
34.	李幼平, 李静, 孙鑫, 等. 循证医学在中国的起源与发展: 献给中国循证医学20周年. 中国循证医学杂志, 2016, 16(1): 2-6.

1. 中华医学会呼吸病学分会. 肺部感染性疾病支气管肺泡灌洗病原体检测中国专家共识(2017年版). 中华结核和呼吸杂志, 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. 韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREE Ⅱ)工具实例解读. 中国循证儿科杂志, 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. 中华医学会呼吸病学分会介入呼吸病学学组. 成人诊断性可弯曲支气管镜检查术应用指南(2019年版). 中华结核和呼吸杂志, 2019, (8): 573-590.
22. 《中华儿科杂志》编辑委员会中华医学会儿科学分会新生儿学组. 新生儿黄疸诊疗原则的专家共识. 中华儿科杂志, 2010, 48(9): 685-686.
23. 国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术专家组, 中国医师协会儿科医师分会内镜专业委员会, 中国医师协会内镜医师分会儿科呼吸内镜专业委员会, 等. 中国儿科可弯曲支气管镜术指南(2018年版). 中华实用儿科临床杂志, 2018, 33(13): 983-989.
24. 国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术项目专家组, 中国医师协会儿科医师分会内镜专业委员会, 中国医师协会内镜医师分会儿科呼吸内镜专业委员会, 等. 中国儿童难治性肺炎呼吸内镜介入诊疗专家共识. 中国实用儿科杂志, 2019, 34(6): 449-457.
25. 李秀霞, 韩雪梅, 杨克虎. 循证卫生政策的发展与展望. 图书与情报, 2018, (3): 43-49.
26. 杨克虎. 循证社会科学的产生、发展与未来. 图书与情报, 2018, (3): 1-10.
27. 杨克虎, 李秀霞, 拜争刚. 循证社会科学研究方法: 系统评价与Meta分析. 兰州: 兰州大学出版社, 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-Eßer 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, 王小钦, 金雪娟, 等. 中国临床实践指南评价体系的制订与初步验证. 中华医学杂志, 2018, 98(20): 1544-1548.
34. 李幼平, 李静, 孙鑫, 等. 循证医学在中国的起源与发展: 献给中国循证医学20周年. 中国循证医学杂志, 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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