scholarly journals Assessment of the methodological quality of local clinical practice guidelines on the identification and management of gestational diabetes

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027285 ◽  
Author(s):  
Bridget Daley ◽  
Graham Hitman ◽  
Norman Fenton ◽  
Scott McLachlan
Keyword(s):  
Clinical Practice ◽  
Gestational Diabetes ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Clinical Decision Making ◽  
Healthcare Delivery ◽  
The Internet ◽  
Agree Ii

ObjectiveGestational diabetes is the most common metabolic disorder of pregnancy, and it is important that well-written clinical practice guidelines (CPGs) are used to optimise healthcare delivery and improve patient outcomes. The aim of the study was to assess the methodological quality of hospital-based CPGs on the identification and management of gestational diabetes.DesignWe conducted an assessment of local clinical guidelines in English for gestational diabetes using the Appraisal of Guidelines for Research and Evaluation (AGREE II) to assess and validate methodological quality.Data sources and eligibility criteriaWe sought a representative selection of local CPGs accessible by the internet. Criteria for inclusion were (1) identified as a guideline, (2) written in English, (3) produced by or for the hospital in a Western country, (4) included diagnostic criteria and recommendations concerning gestational diabetes, (5) grounded on evidence-based medicine and (6) accessible over the internet. No more than two CPGs were selected from any single country.ResultsOf the 56 CPGs identified, 7 were evaluated in detail by five reviewers using the standard AGREE II instrument. Interrater variance was calculated, with strong agreement observed for those protocols considered by reviewers as the highest and lowest scoring based on the instrument. CPG results for each of the six AGREE II domains are presented categorically using a 5-point Likert scale. Only one CPG scored above average in five or more of the domains. Overall scores ranged from 91.6 (the strongest) to 50 (the weakest). Significant variation existed in the methodological quality of CPGs, even though they followed the guideline of an advising body. Specifically, appropriate identification of the evidence relied on to inform clinical decision making in CPGs was poor, as was evidence of user involvement in the development of the guideline, resource implications, documentation of competing interests of the guideline development group and evidence of external review.ConclusionsThe limitations described are important considerations for updating current and new CPGs.

scholarly journals Quality of and Recommendations for Relevant Clinical Practice Guidelines for COVID-19 Management: A Systematic Review and Critical Appraisal

2021 ◽  
Vol 8 ◽  
Author(s):  
Yun-Yun Wang ◽  
Qiao Huang ◽  
Quan Shen ◽  
Hao Zi ◽  
Bing-Hui Li ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Status ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Agree Ii ◽  
Status Monitoring ◽  
Isolation Management ◽  
Diagnosis Criteria

Background: The morbidity and mortality of coronavirus disease 2019 (COVID-19) are still increasing. This study aimed to assess the quality of relevant COVID-19 clinical practice guidelines (CPGs) and to compare the similarities and differences between recommendations.Methods: A comprehensive search was conducted using electronic databases (PubMed, Embase, and Web of Science) and representative guidelines repositories from December 1, 2019, to August 11, 2020 (updated to April 5, 2021), to obtain eligible CPGs. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to evaluate the quality of CPGs. Four authors extracted relevant information and completed data extraction forms. All data were analyzed using R version 3.6.0 software.Results: In total, 39 CPGs were identified and the quality was not encouragingly high. The median score (interquartile range, IQR) of every domain from AGREE II for evidence-based CPGs (EB-CPGs) versus (vs.) consensus-based CPG (CB-CPGs) was 81.94% (75.00–84.72) vs. 58.33% (52.78–68.06) in scope and purpose, 59.72% (38.89–75.00) vs. 36.11% (33.33–36.11) in stakeholder involvement, 64.58% (32.29–71.88) vs. 22.92% (16.67–26.56) in rigor of development, 75.00% (52.78–86.81) vs. 52.78% (50.00–63.89) in clarity of presentation, 40.63% (22.40–62.50) vs. 20.83% (13.54–25.00) in applicability, and 58.33% (50.00–100.00) vs. 50.00% (50.00–77.08) in editorial independence, respectively. The methodological quality of EB-CPGs were significantly superior to the CB-CPGs in the majority of domains (P < 0.05). There was no agreement on diagnosis criteria of COVID-19. But a few guidelines show Remdesivir may be beneficial for the patients, hydroxychloroquine +/– azithromycin may not, and there were more consistent suggestions regarding discharge management. For instance, after discharge, isolation management and health status monitoring may be continued.Conclusions: In general, the methodological quality of EB-CPGs is greater than CB-CPGs. However, it is still required to be further improved. Besides, the consistency of COVID-19 recommendations on topics such as diagnosis criteria is different. Of them, hydroxychloroquine +/– azithromycin may be not beneficial to treat patients with COVID-19, but remdesivir may be a favorable risk-benefit in severe COVID-19 infection; isolation management and health status monitoring after discharge may be still necessary. Chemoprophylaxis, including SARS-CoV 2 vaccines and antiviral drugs of COVID-19, still require more trials to confirm this.

scholarly journals Assessing methodological quality of Russian clinical practice guidelines and introducing AGREE II instrument in Russia

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0203328 ◽  
Author(s):  
Dina Ayratova Lienhard ◽  
Lidiya Vacheslavovna Kisser ◽  
Liliya Eugenevna Ziganshina
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Agree Ii ◽  
Agree Ii Instrument

scholarly journals Critical Appraisal of Clinical Practice Guidelines for the Management of COVID-19: Protocol for a Systematic Review

2020 ◽  
Author(s):  
Thanansayan Dhivagaran ◽  
Umaima Abbas ◽  
Fahad Rasool Butt ◽  
Luckshann Arunasalam ◽  
Oswin Chang
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Healthcare Providers ◽  
High Quality ◽  
Agree Ii ◽  
Agree Ii Instrument

Abstract BackgroundIn December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 was identified as the cause of an acute respiratory disease, coronavirus disease 2019 (COVID-19). Given the lack of validated treatments, there is an urgent need for the high-quality management of COVID-19. Clinical practice guidelines (CPGs) are one tool that healthcare providers may use to enhance patient care. As such, it is necessary that they have access to high-quality evidence-based CPGs upon which they may base decisions regarding the management and use of therapeutic interventions (TI) for COVID-19. The purpose of the proposed study is to assess the quality of CPGs that make management or TI recommendations for COVID-19 using the AGREE II instrument. Methods‌The proposed systematic review will identify CPGs for TI use and/or the management of COVID-19. MEDLINE, EMBASE, CINAHL and Web of Science will be searched from December 2019 up to December 2020. The primary outcome of this study is the assessed quality of the CPGs. The quality of eligible CPGs will be assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Descriptive statistics will be used to quantify the quality of the CPGs. The secondary outcomes of this study are the types of management and/or TI recommendations made. Inconsistent and duplicate TI and/or management recommendations made between CPGs will be compared across guidelines. DiscussionThe results of this study will be of utmost importance to enhancing clinical decision-making among healthcare providers caring for patients with COVID-19. Moreover, the results of this study will be relevant to guideline developers in the creation of CPGs or improvement of existing ones, researchers who want to identify gaps in knowledge, and policy-makers looking to encourage and endorse the adoption of CPGs into clinical practice. The results of this review will be published in a peer-reviewed journal and presented at conferences. Systematic Review ‌Registration‌ ‌International‌ ‌Prospective‌ ‌Register‌ ‌for‌ ‌Systematic‌ ‌Reviews‌ ‌(PROSPERO)‌ ‌—‌ ‌CRD42020219944

scholarly journals Screening and prevention for latent tuberculosis in immunosuppressed patients at risk for tuberculosis: a systematic review of clinical practice guidelines

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022445 ◽  
Author(s):  
Tasnim Hasan ◽  
Eric Au ◽  
Sharon Chen ◽  
Allison Tong ◽  
Germaine Wong
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Latent Tuberculosis ◽  
Average Score ◽  
Agree Ii

ObjectiveImmunosuppressed individuals are at a high risk of latent tuberculosis infection (LTBI) and clinical practice guidelines for the screening and management of LTBI in at-risk patients have been developed. We assessed the scope, quality and consistency of clinical practice guidelines on screening for LTBI and the prevention of tuberculosis infection (TB) in high-risk patient populations.DesignWe conducted a systematic review of clinical practice guidelines. Methodological quality of these guidelines was assessed using the Appraisal of Guidelines for Research and Education (AGREE) II instrument. Textual synthesis was used to summarise and compare the recommendations.Data sourcesElectronic databases (MEDLINE, EMBASE, PsycINFO) and guideline registries were searched from inception to December 2017.ResultsThirty-eight guidelines were included. Nineteen focused on patients receiving medical immunosuppression, seven on transplantation, three on patients with HIV and nine were generalised across all at risk populations. Most guidelines (n=32, 84%) used a systematic approach to identify and appraise the evidence. The methodological quality of the guidelines varied with the overall mean AGREE II scores ranging from 35% to 80%. Guidelines performed poorly in terms of editorial independence (average score 35%, range 0%–92%); however, most were robust in defining their scope and purpose (average score 80%, range 56%–100%). Guidelines recommended either or both the tuberculin skin test and the interferon gamma release assay for screening. Treatment of LTBI with isoniazid was consistently recommended.ConclusionClinical practice guidelines on LTBI vary in quality and scope. The recommendations for screening varied across guidelines, while recommendations for treatment were largely consistent. Improving the consistency and quality of guidelines may help to optimise the screening and management of LTBI for improved patient outcomes.

scholarly journals Methodological quality of systematic reviews referenced in clinical practice guidelines for the treatment of opioid use disorder

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0181927 ◽  
Author(s):  
Andrew Ross ◽  
Justin Rankin ◽  
Jason Beaman ◽  
Kelly Murray ◽  
Philip Sinnett ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals Antenatal magnesium sulfate for fetal neuroprotection: a critical appraisal and systematic review of clinical practice guidelines

2019 ◽  
Vol 47 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Pradeep M. Jayaram ◽  
Manoj K. Mohan ◽  
Ibrahim Farid ◽  
Stephen Lindow
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Magnesium Sulfate ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Supporting Evidence ◽  
Agree Ii ◽  
Fetal Neuroprotection ◽  
Agree Ii Tool

Abstract Background Magnesium sulfate is an accepted intervention for fetal neuroprotection. There are some perceived differences in the international recommendations on the use magnesium sulfate for fetal neuroprotection in preterm labor. Content This systematic review analyses the available clinical guidelines for the use of magnesium sulfate for fetal neuroprotection and compares the recommendations, and assesses the quality of guidelines. This provides the consensus, differences and explores the areas for future collaborative research. We searched databases of PUBMED, EMBASE, COCHRANE, Web of Science, LILACS; and included the national and the international clinical practice guidelines. We included seven guidelines out of 227 search results. We evaluated the methodological quality of guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE II) tool and systematically extracted guideline characters, recommendation and supporting evidence base. Summary Five guidelines were of high quality and two were of moderate quality. One guideline achieved more than an 80% score in all the domains of AGREE II tool. All guidelines recommend use of magnesium sulfate for fetal neuroprotection. However, there are differences in other recommendations such as upper gestational age, dose, duration, repeating treatment and use of additional tocolytics. Outlook Future guidelines should include recommendations on all aspects of magnesium sulfate therapy for fetal neuroprotection. Future research and international collaboration should focus on areas where there are no international consensual recommendations.

scholarly journals Methodological quality of clinical practice guidelines for genetic testing in children

Medicine ◽  
2019 ◽  
Vol 98 (52) ◽  
pp. e18521 ◽  
Author(s):  
Xue-Feng Jiao ◽  
Hai-Long Li ◽  
Liang Cheng ◽  
Chuan Zhang ◽  
Chun-Song Yang ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Genetic Testing ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality
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