Objective

To evaluate the quality of existing clinical practice guidelines for headache management and their main recommendations.

Background

Evidence-based clinical practice guidelines have been developed to support the clinical decision-making. However, to achieve this goal, the quality of these guidelines must be ensured.

Methods

A systematic search for clinical practice guidelines for headache management was conducted in the PubMed database, in websites of known guideline developers and in websites of known headache associations. The quality appraisal was performed through the Appraisal of Guidelines for Research and Evaluation II method.

Results

Twelve guidelines were evaluated. The domains of rigor of development, applicability, and editorial independence, which most influence the overall quality of guidelines, had the lowest average scores and the highest standard deviation rates (61% ± 23; 37% ± 20; 53% ± 31). The main recommendations regarding medication use for acute treatment of episodic tension-type headache and migraine in adult patients consisted of paracetamol, acetylsalicylic acid, and other nonsteroidal anti-inflammatory drugs in all guidelines.

Conclusions

The statistical results indicate that the appraised guidelines have room for both individual and collective improvement. In addition, there is a well-established medication recommendation pattern among all guidelines evaluated.

中文翻译：

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通过 AGREE II 方法对现有头痛疾病管理指南的质量评估

目标

评估现有头痛管理临床实践指南的质量及其主要建议。

背景

已经制定了循证临床实践指南以支持临床决策。但是，要实现这一目标，必须确保这些指南的质量。

方法

在 PubMed 数据库、已知指南制定者的网站和已知头痛协会的网站中对头痛管理的临床实践指南进行了系统搜索。质量评价通过《研究与评价指南评价II》方法进行。

结果

评估了 12 项指南。对指南整体质量影响最大的发展严谨性、适用性和编辑独立性领域的平均得分最低，标准偏差率最高（61%±23；37%±20；53%±31）。在所有指南中，关于急性治疗成人患者发作性紧张型头痛和偏头痛的药物使用的主要建议包括扑热息痛、乙酰水杨酸和其他非甾体抗炎药。

结论

统计结果表明，被评估的指南有个人和集体改进的空间。此外，在所有评估的指南中都有一个完善的药物推荐模式。