scholarly journals Assessing Clinical Microbiology Practice Guidelines: American Society for MicrobiologyAd HocCommittee on Evidence-Based Laboratory Medicine Practice Guidelines Assessment

2017 ◽  
Vol 55 (11) ◽  
pp. 3183-3193 ◽  
Author(s):  
Irving Nachamkin ◽  
Thomas J. Kirn ◽  
Lars F. Westblade ◽  
Romney Humphries
Keyword(s):  
Practice Guidelines ◽  
Ad Hoc ◽  
Assessment Tool ◽  
Research Evaluation ◽  
Laboratory Medicine ◽  
Evidence Based ◽  
Emergency Nurses ◽  
Agree Ii ◽  
American Society ◽  
Practice Committee

ABSTRACTAs part of the American Society for Microbiology (ASM) Evidence-Based Laboratory Medicine Practice Guidelines Committee of the Professional Practice Committee, anad hoccommittee was formed in 2014 to assess guidelines published by the committee using an assessment tool, Appraisal of Guidelines for Research Evaluation II (AGREE II). The AGREE II assessment helps reviewers determine whether published guidelines are robust, transparent, and clear in presenting practice recommendations in a standardized manner. Identifying strengths and weaknesses of practice guidelines byad hocassessments helps with improving future guidelines through the participation of key stakeholders. This minireview describes the development of thead hoccommittee and results from their review of several ASM best practices guidelines and a non-ASM practice guideline from the Emergency Nurses Association.

scholarly journals Overview of evidence-based clinical practice guidelines for preoperative care: a systematic review.

2020 ◽  
Author(s):  
Agustín Ciapponi ◽  
Tapia-López Elena ◽  
Virgilio Sacha ◽  
Ariel Bardach
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cochrane Library ◽  
Evidence Based ◽  
Agree Ii ◽  
Quality Of Evidence ◽  
Moderate Quality

Abstract Background Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs). Methods Systematic review of clinical practice guidelines. Data sources: PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence and strength of recommendations according to the GRADE methodology. Results We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last five years and seven used GRADE. The median (percentile 25-75) AGREE-II scores for rigor of development was 49% (35-76%) and the domain ‘applicability’ obtained the worst score: 16% (9-31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. ‘Guidelines’ applicability’ and ‘monitoring’ were the most deficient domains. Only half of the EB-CPGs were updated in the past five years. Conclusions We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines’ quality.

scholarly journals Australasian paramedic clinical practice guidelines for managing cardiac arrest: an appraisal

2019 ◽  
Vol 16 ◽  
Author(s):  
Marc Colbeck ◽  
Andrew Swain ◽  
Jonathan Gibson ◽  
Lachlan Parker ◽  
Paul Bailey ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Clinical Practice ◽  
Best Practices ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Lead Author ◽  
Evidence Based ◽  
Clinical Use ◽  
Agree Ii ◽  
Agree Ii Instrument

IntroductionThere are 10 government-regulated ambulance services (paramedic provider services) in Australasia who are members of the Council of Ambulance Authorities (CAA). These CAA-member services each produce clinical practice guidelines (CPGs), which guide the practice of their paramedics. Common to each set of CAA-member CPG is a guideline that addresses cardiac arrest due to ventricular fibrillation and pulseless ventricular tachycardia (pulseless VT/VF). This study sought to answer the question: ‘Are current CAA-member CPGs developed with sufficient methodological rigour to consistently produce guidelines that, according to validated, evidence-based best practices, can be recommended for clinical use?’MethodsThis question was addressed by performing a comparison of existing CAA-member CPGs for pulseless VT/VF against the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument. All CPGs were anonymised and sent to each appraiser along with the AGREE II appraisal sheet. Appraisals were conducted independently for each CPG and returned to the lead author for collation. The anonymised results were then shared among all appraisers for consideration and discussion. Appraisers were free to change their appraisal after considering the comments from the other appraisers, and results were then converted into a final percent score for each CPG in accord with the recommended AGREE II instrument methodology. One appraisal question, in addition to the AGREE II criteria was added to each appraisal; the response to this was analysed separately.ResultsNine CPGs were evaluated according to the AGREE II instrument. The appraisers gave passing marks to only two of the six domains in the AGREE II instrument: Domain 1 – Scope and Purpose (73%), and Domain 4 – Clarity of Presentation (74%). Less than passing marks were awarded for Domain 2 – Stakeholder Involvement (27%). Scores of less than 10% were awarded for Domain 5 – Applicability (8%) and Editorial Independence (1%).ConclusionBased on the findings of this paper, the authors conclude that it cannot be assumed that current CAA-member paramedic CPGs are developed with sufficient methodological rigour to consistently produce guidelines that, according to validated, evidence-based best practices can be recommended for clinical use. However, most of the authors agree that the CPGs reviewed could be recommended for clinical use with relatively minor modifications. It would be useful to determine whether end users of the CAA-member CPGs agree on the importance of characteristics of CPGs that the AGREE II instrument appraises.

scholarly journals Quality assessment of evidence-based clinical practice guidelines for the management of pregnant women with sickle cell disease using the AGREE II instrument: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yasser S. Amer ◽  
Yasser Sabr ◽  
Ghada M. ElGohary ◽  
Amer M. Altaki ◽  
Osamah T. Khojah ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Evidence Based ◽  
Cell Disease ◽  
Agree Ii ◽  
Agree Ii Instrument

Abstract Background The management of pregnant women with sickle cell disease (SCD) poses a major challenge for maternal healthcare services owing to the potential for complications associated with morbidity and mortality. Trustworthy evidence-based clinical practice guidelines (CPGs) have a major impact on the positive outcomes of appropriate healthcare. The objective of this study was to critically appraise the quality of recent CPGs for SCD in pregnant women. Methods Clinical questions were identified and the relevant CPG and bibliographic databases were searched and screened for eligible CPGs. Each CPG was appraised by four independent appraisers using the AGREE II Instrument. Inter-rater analysis was conducted. Results Four eligible CPGs were appraised: American College of Obstetricians and Gynecologists (ACOG), National Heart, Lung, and Blood Institute (NHLBI), National Institute of Health and Care Excellence (NICE), and Royal College of Obstetricians and Gynaecologists (RCOG). Among them, the overall assessments of three CPGs (NICE, RCOG, NHLBI) scored greater than 70%; these findings were consistent with the high scores in the six domains of AGREE II, including:[1] scope and purpose,[2] stakeholder involvement,[3] rigor of development,[4] clarity of presentation,[5] applicability, and [6] editorial independence domains. Domain [3] scored (90%, 73%, 71%), domain [5] (90%, 46%, 47%), and domain [6] (71%, 77%, 52%) for NICE, RCOG, and NHLBI, respectively. Overall, the clinical recommendations were not significantly different between the included CPGs. Conclusions Three evidence-based CPGs presented superior methodological quality. NICE demonstrated the highest quality followed by RCOG and NHLBI and all three CPGs were recommended for use in practice.

Use of Hematopoietic Colony-Stimulating Factors: Comparison of the 1994 and 1997 American Society of Clinical Oncology Surveys Regarding ASCO Clinical Practice Guidelines

1999 ◽  
Vol 17 (11) ◽  
pp. 3676-3681 ◽  
Author(s):  
Charles L. Bennett ◽  
Jane A. Weeks ◽  
Mark R. Somerfield ◽  
Joe Feinglass ◽  
Thomas J. Smith
Keyword(s):  
Febrile Neutropenia ◽  
Clinical Oncology ◽  
Practice Guidelines ◽  
Palliative Therapy ◽  
Lower Lobe ◽  
Primary Prophylaxis ◽  
Secondary Prophylaxis ◽  
Evidence Based ◽  
Clinical Scenarios ◽  
American Society

PURPOSE: The American Society of Clinical Oncology (ASCO) Health Services Research Committee sought to assess whether more appropriate patterns of colony-stimulating factor (CSF) use occurred after the publication of ASCO evidence-based practice guidelines in 1994 and 1996 for patients with solid tumors or lymphoma. METHODS: In 1994 and 1997, questionnaires describing clinical scenarios were mailed to ASCO members who practiced medical oncology. Physicians were asked the extent to which they preferred to use a CSF for primary prophylaxis, secondary prophylaxis, or treatment of neutropenic complications. Multiple regression analyses were used to determine predictors of overall propensity to use CSFs and, when using a CSF, propensity to support longer schedules of CSF use. RESULTS: Decreased use of CSFs was shown in the following situations: (1) treatment for febrile neutropenia without localizing signs (39% in 1994 v 29% in 1997) or with a right lower lobe infiltrate (54% v 46%); (2) primary prophylaxis with paclitaxel for ovarian cancer (20% v 11%) or cyclophosphamide, doxorubicin, and vincristine chemotherapy for small-cell lung cancer (8.4% v 4.6%); and (3) secondary prophylaxis after afebrile neutropenia following chemotherapy for germ cell tumors (44.5% v 36.0%). One third fewer physicians supported the extended use of CSFs until an absolute neutrophil count ≥ 10,000/mm3 or a WBC count ≥ 10,000/mm3 was reached, both counts serving as criteria for stopping CSF therapy. However, we observed high rates of CSF use despite ASCO guideline recommendations against use in the following clinical situations: (1) primary prophylaxis in patients at low risk of febrile neutropenia (6% v 16%); (2) secondary prophylaxis late in the course of curative and palliative therapy (80% v 53%); and (3) treatment of afebrile and uncomplicated febrile neutropenia (30% v 60%). In 1994 and 1997, fee-for-service physicians were more likely than other physicians to prefer use of CSF support while maintaining treatment dose and schedule instead of using dose-reduction strategies, and, when using a CSF, they were more likely to support longer CSF treatment schedules (P < .05 for both scenarios). CONCLUSION: Decreased use and more appropriate use of CSFs in accordance with ASCO guideline recommendations occurred from 1994 to 1997, but there remain many opportunities to reduce CSF use with no clinical harm. Many oncologists continue to support the use of CSFs in scenarios and with scheduling criteria that the guidelines and evidence do not support. ASCO's evidence-based guidelines should be linked with formal continuous quality improvement initiatives to substantially improve the quality of supportive oncology care.

scholarly journals Transitioning toward Evidence-Based Research in the Health Sciences for the XXI Century

2008 ◽  
Vol 5 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Francesco Chiappelli ◽  
Olivia S. Cajulis
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Research Evaluation ◽  
Clinical Intervention ◽  
Health Sciences ◽  
Clinical Applications ◽  
Evidence Based ◽  
Levels Of Evidence ◽  
Evidence Based Dentistry

This article discusses some of the misconceptions of evidence-based research in the health sciences. It proposes that since not all treatments in medicine and dentistry can be evidence-based, clinical applications of the evidence-based process should become a specialty. The case is particularly evident in dentistry. Therefore dentistry is taken in this article as a model for discussion. We propose that to approach dentistry from the viewpoint of the patient-oriented evidence that matters (POEM) is perfectly acceptable so far as we also engage in the process of research evaluation and appraisal in dentistry (READ). We distinguish between dentistry based on the evidence, and evidence-based dentistry. We argue that when invoking an evidence-based approach to dentistry or medicine, it is not sufficient to establish the ‘levels of evidence’, but rather that all evidence-based clinical intervention must undergo the stringent process of evidence-based research so that clinical practice guidelines be revised based on the best available evidence.

PP554 Quality Assessment Of Clinical Practice Guidelines On Chronic Obstructive Pulmonary Disease Based On The Appraisal Of Guidelines For Research And Evaluation II (AGREE II) Instrument

2020 ◽  
Vol 36 (S1) ◽  
pp. 42-42
Author(s):  
Qian Xu ◽  
Kun Zhao ◽  
Cheng A Xin Duan ◽  
Dandan Ai ◽  
Binyan Sui
Keyword(s):  
Clinical Practice ◽  
Practice Guidelines ◽  
Chronic Obstructive ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Agree Ii ◽  
Obstructive Pulmonary Disease ◽  
Evidence Based Guidelines ◽  
Agree Ii Instrument

IntroductionThe scientific application of clinical evidence-based guidelines can reduce the variability of clinical practice, and standardize clinical diagnosis and treatment pathways. At present, many evidence-based guidelines on Chronic Obstructive Pulmonary Disease (COPD) prevention have been issued in countries around the world, but the procedures and evaluation strategies developed by different guidelines are not the same. This study aimed to evaluate the quality of published clinical practice guidelines (CPGs) relating to COPD using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.MethodsDatabases were systematically searched PubMed, EMBASE, Wan Fang, and CNKI as well as guidelines websites on COPD prevention and treatment. The search period was from inception of the database up to May 2019. The inclusion criteria for this study are as follows: (i) published and in accordance with the definition of the practice guidelines; (ii)the main target population is COPD patients with the diagnostic criteria of the 2019 edition of the global initiative for COPD (GOLD), and the content of the guideline is related to the prevention and treatment practice of COPD; (ii) the same guide is included in the latest updated version; (iv) the published language is English or Chinese. Guidelines that met these inclusion criteria were evaluated for the quality of the AGREE II guidelines. Then, a descriptive analysis was made of the consensus that exists in the guidelines.ResultsA total of fifteen guidelines/Consensuses Statements were included in the study. Two guidelines were assessed as recommended, eleven guidelines were assessed as recommended with modifications and two guidelines were not recommended. The mean scores of the included guidelines in the six domains (scope and purpose, personnel involved in guideline development, rigor of development, clarity, applicability, independence) were 90 percent, 72 percent, 49 percent, 96 percent, 60 percent, 69 percent, respectively. Thus, the study identified a consensus that disease risk factors and recommended interventions were mentioned in the guidelines, and that they comprehensively evaluated the quality of guideline reporting to provide reference for standardizing the development of practice guidelines for COPD in China.ConclusionsThe overall methodological quality of COPD CPGs should be improved. The key recommended areas for improvement include standardization of guideline report writing and synthesis of the latest and best evidence, to develop CPGs for COPD to improve the quality of clinical diagnosis and treatment for COPD.

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