scholarly journals A technical appraisal of guidelines for the management of skin rash in patients on chemotherapy and targeted therapy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fangyuan Zhang ◽  
Sumei Lv ◽  
Yating Feng ◽  
Xuan Yang ◽  
Wanmin Qiang
Keyword(s):  
Targeted Therapy ◽  
Skin Rash ◽  
Methodological Quality ◽  
Guideline Development ◽  
Quality Care ◽  
Stakeholder Involvement ◽  
Inclusion Criteria ◽  
Care Guidelines ◽  
Technical Appraisal

Abstract Background Skin rash remains one of the most prevalent and troublesome clinical problems experienced by patients on chemotherapy and targeted therapy. To ensure high-quality care, guidelines are seen as the best guidance. Considering the quality of guidelines varies greatly, a systematical appraisal of the methodological quality of guidelines for the management of skin rash in patients on chemotherapeutic drugs and targeted anticancer therapies was undertaken, in order to identify appropriate ones for healthcare professionals. Methods A systematic search of databases and Internet was conducted to obtain pertinent guidelines. Two reviewers independently assessed the eligibility of guidelines according to the inclusion criteria. Then the guidelines included were appraised by three researchers with the methodological quality of eligible guideline using Appraisal of Guidelines for Research and Evaluation II (AGREEII). Results Totally nineteen guidelines met the inclusion criteria. The quality ranged from good to acceptable in scope and purpose (mean: 78.80%, range: 66.67–94.44%) and clarity of presentation domains (mean: 85.38%, 75.00–91.67%), but not in stakeholder involvement (mean: 50.15%, range: 36.11–75.00%), rigor of development (mean: 23.65%, range: 6.25–70.83%), applicability (mean: 23.96%, range: 4.17–52.08%), and editorial independence domains (mean: 45.18%, range: 0.00–87.50%). Overall, two guidelines were classified as “recommended”. Conclusions Only two guidelines were recommended to manage skin rash in patients on chemotherapy and targeted therapies, most guidelines issued were of low to moderate quality. Thus, more attention should be paid to the methodological quality of guideline development in this field.

scholarly journals Evaluation of clinical practice guidelines (CPG) on the management of female chronic pelvic pain (CPP) using the AGREE II instrument

2021 ◽  
Author(s):  
Vishalli Ghai ◽  
Venkatesh Subramanian ◽  
Haider Jan ◽  
Jemina Loganathan ◽  
Stergios K. Doumouchtsis ◽  
...  
Keyword(s):  
Surgical Management ◽  
Guideline Development ◽  
Stakeholder Involvement ◽  
Professional Organizations ◽  
Agree Ii ◽  
Behavioural Interventions ◽  
Recommended Treatment ◽  
Muscular Dysfunction ◽  
Health Related

Abstract Introduction and hypothesis Variations in guidelines may result in differences in treatments and potentially poorer health-related outcomes. We aimed to systematically review and evaluate the quality of national and international guidelines and create an inventory of CPG recommendations on CPP. Methods We searched EMBASE and MEDLINE databases from inception till August 2020 as well as websites of professional organizations and societies. We selected national and international CPGs reporting on the diagnosis and management of female CPP. We included six CPGs. Five researchers independently assessed the quality of included guidelines using the AGREE II tool and extracted recommendations. Results Two hundred thirty-two recommendations were recorded and grouped into six categories: diagnosis, medical treatment, surgical management, behavioural interventions, complementary/alternative therapies and education/research. Thirty-nine (17.11%) recommendations were comparable including: a comprehensive pain history, a multi-disciplinary approach, attributing muscular dysfunction as a cause of CPP and an assessment of quality of life. Two guidelines acknowledged sexual dysfunction associated with CPP and recommended treatment with pelvic floor exercises and behavioural interventions. All guidelines recommended surgical management; however, there was no consensus regarding adhesiolysis, bilateral salpingo-oophorectomy during hysterectomy, neurectomy and laparoscopic uterosacral nerve ablation. Half of recommendations (106, 46.49%) were unreferenced or made in absence of good-quality evidence or supported by expert opinion. Based on the AGREE II assessment, two guidelines were graded as high quality and recommended without modifications (EAU and RCOG). Guidelines performed poorly in the “Applicability”, “Editorial Independence” and “Stakeholder Involvement” domains. Conclusion Majority of guidelines were of moderate quality with significant variation in recommendations and quality of guideline development.

scholarly journals Do Guidelines for the Diagnosis and Monitoring of Diabetes Mellitus Fulfill the Criteria of Evidence-Based Guideline Development?

2008 ◽  
Vol 54 (11) ◽  
pp. 1872-1882 ◽  
Author(s):  
Eva Nagy ◽  
Joseph Watine ◽  
Peter S Bunting ◽  
Rita Onody ◽  
Wytze P Oosterhuis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Methodological Quality ◽  
Guideline Development ◽  
Evidence Based ◽  
Test Results ◽  
Time Period ◽  
Therapeutic Guidelines ◽  
Therapeutic Recommendations ◽  
Evidence Based Guideline

Abstract Background: Although the methodological quality of therapeutic guidelines (GLs) has been criticized, little is known regarding the quality of GLs that make diagnostic recommendations. Therefore, we assessed the methodological quality of GLs providing diagnostic recommendations for managing diabetes mellitus (DM) and explored several reasons for differences in quality across these GLs. Methods: After systematic searches of published and electronic resources dated between 1999 and 2007, 26 DM GLs, published in English, were selected and scored for methodological quality using the AGREE Instrument. Subgroup analyses were performed based on the source, scope, length, origin, and date and type of publication of GLs. Using a checklist, we collected laboratory-specific items within GLs thought to be important for interpretation of test results. Results: The 26 diagnostic GLs had significant shortcomings in methodological quality according to the AGREE criteria. GLs from agencies that had clear procedures for GL development, were longer than 50 pages, or were published in electronic databases were of higher quality. Diagnostic GLs contained more preanalytical or analytical information than combined (i.e., diagnostic and therapeutic) recommendations, but the overall quality was not significantly different. The quality of GLs did not show much improvement over the time period investigated. Conclusions: The methodological shortcomings of diagnostic GLs in DM raise questions regarding the validity of recommendations in these documents that may affect their implementation in practice. Our results suggest the need for standardization of GL terminology and for higher-quality, systematically developed recommendations based on explicit guideline development and reporting standards in laboratory medicine.

Quality and Risk of Bias in Panax ginseng Randomized Controlled Trials: A Review

2013 ◽  
Vol 41 (02) ◽  
pp. 231-252 ◽  
Author(s):  
Johannah L. Shergis ◽  
Anthony L. Zhang ◽  
Wenyu Zhou ◽  
Charlie C. Xue
Keyword(s):  
Randomized Controlled Trials ◽  
Panax Ginseng ◽  
Methodological Quality ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Publication Date ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Clinical Benefits

Panax ginseng is one of the most frequently used herbs in the world. Numerous trials have evaluated its clinical benefits. However, the quality of these studies has not been comprehensively and systematically assessed. We reviewed randomized controlled trials (RCTs) of Panax ginseng to evaluate their quality and risk of bias. We searched four English databases, without publication date restriction. Two reviewers extracted details about the studies' methodological quality, guided by the Consolidated Standards of Reporting Trials (CONSORT) checklist and its extension for herbal interventions. Risk of bias was determined using the Cochrane Risk of Bias tool. Of 475 potentially relevant studies, 58 met our inclusion criteria. In these 58 studies, 48.3% of the suggested CONSORT checklist items and 35.9% of the extended herbal items were reported. The quality of RCTs published after the CONSORT checklist improved. Until 1995 (before CONSORT) (n = 4), 32.8% of the items were reported in studies. From 1996–2006 (CONSORT published and revised) (n = 30), 46.1% were reported, and from 2007 (n = 24), 53.5% were reported (p = 0.005). After the CONSORT extension for herbal interventions was published in 2006, RCT quality also improved, although not significantly. Until 2005 (n = 34), 35.2% of the extended herbal items were reported in studies; and from 2006 onwards (n = 24), 37.3% were reported (p = 0.64). Most studies classified risk of bias as "unclear". Overall, the quality of Panax ginseng RCT methodology has improved since the CONSORT checklist was introduced. However, more can be done to improve the methodological quality of, and reporting in, RCTs.

scholarly journals The quality of guidelines in non-pharmacological prevention and management of chemotherapy-induced neuropathy: A review

2018 ◽  
Author(s):  
Shahin Salarvand ◽  
Simin Hemati ◽  
Payman Adibi ◽  
Fariba Taleghani
Keyword(s):  
Methodological Quality ◽  
Stakeholder Involvement ◽  
Common Adverse Effect ◽  
Adaptation Process ◽  
Medical Sciences ◽  
High Quality ◽  
Agree Ii ◽  
Pharmacological Prevention ◽  
Agree Ii Instrument

Chemotherapy-induced peripheral neuropathy is a common adverse effect occurring in patients undergoing neurotoxic chemotherapy. However, there is no FDA-approved treatment option for it. Given the importance of clinical practice guidelines in this area, this study aimed to determine the methodological quality of extant CIPN guidelines. The study was done as part of the adaptation process of CIPN related CPGs at Isfahan University of Medical Sciences, Iran. A systematic search of published CPGs about chemotherapy-induced CIPN in which the AGREE II instrument was applied for appraising CPGs of CIPN was performed. In general, amongst all of the AGREE II Instrument’s domains in the evaluated CPGs, the clarity of presentation and stakeholder involvement domains took favorable scores; and other domains obtained unfavorable and relatively favorable scores. The quality of cancer therapy-induced neuropathy CPGs needs to be improved and designing high-quality CPGs must be considered.

scholarly journals Systematic review of the psychometric properties of patient-reported outcome measures for rheumatoid arthritis in the foot and ankle

2019 ◽  
Vol 33 (11) ◽  
pp. 1788-1799 ◽  
Author(s):  
Ana Belen Ortega-Avila ◽  
Laura Ramos-Petersen ◽  
Pablo Cervera-Garvi ◽  
Christopher J Nester ◽  
José Miguel Morales-Asencio ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Psychometric Properties ◽  
Outcome Measures ◽  
Methodological Quality ◽  
Measurement Properties ◽  
Foot And Ankle ◽  
Inclusion Criteria ◽  
Patient Reported

Objective: To identify self-reported outcome measures specific to the foot and ankle in patients with rheumatoid arthritis and to investigate the methodological quality and psychometric properties of these measures. Method: A systematic review focusing on patients with rheumatoid arthritis. Setting: The search was conducted in the PubMed, SCOPUS, CINAHL, PEDro and Google Scholar databases, based on the following inclusion criteria: population (with rheumatoid arthritis) > 18 years; psychometric or clinimetric validation studies of patient-reported outcomes specific to the foot and ankle, in different languages, with no time limit. Two of the present authors independently assessed the quality of the studies located and extracted the relevant data. Terwee’s criteria and the COSMIN checklist were employed to ensure adequate methodological quality. Results: Of the initial 431 studies considered, 14 met the inclusion criteria, representing 7,793 patients (56.8 years). These instruments were grouped into three dimensions (pain, perceived health status and quality of life and disability). The time to complete any of the PROMs varies around 15 minutes. PROMs criterias with the worst scores by COSMIN, 92.85% and 85.71% were criterion validity, measurement error, internal consistency and responsiveness. 28.57% of PROMs were compared with the measurement properties. Conclusion: the Self-Reported Foot and Ankle Score achieved the highest number of positive criteria (according to Terwee and COSMIN), and is currently the most appropriate for patients with Rheumatoid arthritis.

Systematic review of youth mental health service integration research

2016 ◽  
Vol 22 (4) ◽  
pp. 304 ◽  
Author(s):  
Irina Kinchin ◽  
Komla Tsey ◽  
Marion Heyeres ◽  
Yvonne Cadet-James
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Methodological Quality ◽  
Service Integration ◽  
Youth Mental Health ◽  
Inclusion Criteria

Quality mental health care is based on the integration of care across organisations and disciplines. The aims of this study were, first, to assess the extent, characteristics and reported outcomes of publications concerned with youth mental health service integration in Australia and internationally; and second, to investigate the study design quality of evaluative interventions and determine whether the studies report on the cost-effectiveness of the integration in order to inform the reform of youth mental health services by Queensland Health. A systematic search of the peer-reviewed literature and a narrative synthesis were undertaken of English language publications from 21 electronic databases. Inclusion criteria were: published 1998–2014 (inclusive); peer-reviewed research; focused on mental health services integration; reported data for youth aged 12–25 years. The methodological quality of evaluative interventions was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project (EPHPP). Twenty-five studies met the inclusion criteria: one (4%) was classified as a measurement research, 13 (52%) as descriptive, and 11 (44%) as interventions including five (45%) evaluative interventions. Four out of the five evaluative interventions reported positive effects of youth mental health service integration. Particular problems included ambiguity of definitions, absence of economic or cost analyses and insufficient consumer involvement. The methodological quality of the interventions was variable with, on average, a moderate level of selection bias and study design. Despite a slight increase in the number of studies in the last couple of years, there are important gaps in the evidence base for youth mental health service integration processes. The relatively small number of evaluative studies and lack of economic evaluations point to the need for additional research in this important area.

scholarly journals Methodological quality of public health guideline recommendations on vitamin D and calcium : a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031840 ◽  
Author(s):  
Zhaoli Dai ◽  
Cynthia M Kroeger ◽  
Sally McDonald ◽  
Matthew J Page ◽  
Joanne E McKenzie ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Vitamin D ◽  
Bone Health ◽  
Methodological Quality ◽  
Guideline Development ◽  
Grey Literature ◽  
Dietary Guidelines ◽  
Published Data

IntroductionCurrent recommendations for vitamin D and calcium in dietary guidelines and bone health guidelines vary significantly among countries and professional organisations. It is unknown whether the methods used to develop these recommendations followed a rigourous process and how the differences in methods used may affect the recommended intakes of vitamin D and calcium. The objectives of this study are (1) collate and compare recommendations for vitamin D and calcium across guidelines, (2) appraise methodological quality of the guideline recommendations and (3) identify methodological factors that may affect the recommended intakes for vitamin D and calcium. This study will make a significant contribution to enhancing the methodological rigour in public health guidelines for vitamin D and calcium recommendations.Methods and analysesWe will conduct a systematic review to evaluate vitamin D and calcium recommendations for osteoporosis prevention in generally healthy middle-aged and older adults. Methodological assessment will be performed for each guideline against those outlined in the 2014 WHO handbook for guideline development. A systematic search strategy will be applied to locate food-based dietary guidelines and bone health guidelines indexed in various electronic databases, guideline repositories and grey literature from 1 January 2009 to 28 February 2019. Descriptive statistics will be used to summarise the data on intake recommendation and on proportion of guidelines consistent with the WHO criteria. Logistic regression, if feasible, will be used to assess the relationships between the methodological factors and the recommendation intakes.Ethics and disseminationEthics approval is not required as we will only extract published data or information from the published guidelines. Results of this review will be disseminated through conference presentations and peer-reviewed publications.PROSPERO registration numberCRD42019126452

scholarly journals Analysis of the Status and Trends of Chinese Clinical Practice Guideline Development Between 2010 and 2020: A Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Rong Zhang ◽  
Si-yu Yan ◽  
Yun-yun Wang ◽  
Qiao Huang ◽  
Xiang-ying Ren ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Methodological Quality ◽  
Evidence Based ◽  
Healthcare Decision ◽  
Inclusion Criteria ◽  
Healthcare Decision Making ◽  
Status And Trends ◽  
The Status

Objective: This study aimed to systematically review the status and trends of Chinese clinical practice guidelines (CPGs) during the time period 2010–2020 and explore their methodological characteristics. Then, based on the strengths and weaknesses in development, offer several recommendations for the quality improvement which will serve as a reference for the users and developers of CPG.Introduction: With the development of evidence-based medicine (EBM), the CPGs play an increasingly important role in healthcare decision-making both in China and worldwide.Inclusion criteria: The CPGs that have been used to help the health professionals in the healthcare decision-making were included.Methodology: The China National Knowledge Infrastructure (CNKI) and WanFang databases were searched from 2010 to 2020 for the studies describing the general and methodological characteristics of Chinese CPGs. Comparisons of the methodological characteristics between the groups were conducted using the chi-square test or Fisher's exact test. The M-K test was adopted to identify the monotonically increasing or decreasing trends of methodological characteristics over the timespan.Results: A total of 2,654 CPGs fulfilled the inclusion criteria. The quantity and quality of the guidelines developed in China have improved over the time span. From 2010 to 2020,the guidelines had differing characteristics and covered a wide range of subjects. In total, 2,318(87.34%) guidelines focused on Western Medicine. Eight (0.30%) had been developed for patient versions of guidelines, 10(0.38%) were tentative guidelines, and 16(0.60%) were rapid advice guidelines. Medical specialty societies (including their branches) (71.1%) were the main guideline makers. The most addressed diseases were neoplasms (14.43%). The target population is mainly adults (84.97%). The methodological quality of consensus-based (CB)-CPGs was obviously lower than evidence-based (EB)-CPGs. Except for the item, “recommendations were based on evidence of systematic reviews,” there were statistical differences in all other methodological items between the EB-CPGS and CB-CPGS (P < 0.01). Higher methodological quality has been observed in EB-CPGs. All the data relating to the methodological characteristics indicated that higher methodological quality was present in the guidelines using GRADE (P < 0.01).Conclusion: The quantity and quality of the guidelines developed in China have improved between 2010 and 2020. CB-CPGs have also paid attention to the methodology quality, but obviously, this is lower than that in the EB-CPGs.

Measurement of quality of care for adjuvant chemotherapy of colorectal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6071-6071
Author(s):  
M. Morse ◽  
R. Prosnitz ◽  
C. Mantyh ◽  
D. Fisher ◽  
G. Samsa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Quality Care ◽  
Future Research ◽  
Inclusion Criteria ◽  
Policy Makers ◽  
Leverage Points ◽  
Stage Iii Colon Cancer ◽  
Crucial Component

6071 Background: Although adjuvant chemotherapy (CT) is a crucial component of the therapy for stage III colon cancer and stage II and III rectal cancer patients, little is known about how best to measure whether quality care is being delivered. We sought to provide policy-makers and stake-holders with an inventory of the available measures and their usefulness. Methods: The MEDLINE and Cochrane databases were searched for all publications which might contain quality measures (QMs) pertaining to the diagnosis and treatment of patients with colorectal cancer (CRC). Our analysis was confined to QMs pertaining to adjuvant CT for CRC, based on US data, and published after 1990. Identified QMs were quantitatively rated based on the concepts of importance/usability, scientific acceptability, and validity or how well they had been tested. Results: 3,429 abstracts were reviewed, of which 843 articles underwent full text evaluation. Ultimately 74 articles met the established inclusion criteria for containing QMs, 32 of which pertained to adjuvant CT. These 32 articles contained 10 QMs, 8 of which had major flaws limiting their applicability. The two most ideal measures are presented in the table . Among the reasons some measures did not rate highly was the failure to utilize standard staging definitions or reliance on administrative inpatient databases, which do not account for chemotherapy administered on an out-patient basis. Conclusions: Very few measures of the quality of adjuvant CT for CRC have been published to date and fewer rate highly with regard to the concepts of importance/usability, scientific acceptability, and validity. Future research should focus on refining existing QMs and on developing new QMs which target important leverage points with respect to the provision of adjuvant therapy for CRC. [Table: see text] [Table: see text]

Findings and Methodological Quality of Systematic Reviews Focusing on Acupuncture for Pregnancy-Related Acute Conditions

2018 ◽  
Vol 36 (3) ◽  
pp. 146-152 ◽  
Author(s):  
Thaís Romera Bergamo ◽  
Carolina de Oliveira Cruz Latorraca ◽  
Daniela Vianna Pachito ◽  
Ana Luiza Cabrera Martimbianco ◽  
Rachel Riera
Keyword(s):  
Back Pain ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Breech Presentation ◽  
Nausea And Vomiting ◽  
Inclusion Criteria ◽  
Acute Conditions ◽  
Meta Analyses ◽  
Clinical Conditions

Introduction Major concerns regarding the use of medication during pregnancy justify the need for safer interventions. Acupuncture is an emerging alternative for several clinical conditions during this period. The objective of this study is to summarise evidence derived from systematic reviews (SRs) focusing on acupuncture for pregnancy-related acute conditions. Methods Review of SRs. A systematic literature search was carried out in several electronic databases, aiming to include all SRs assessing the effects of acupuncture for acute conditions during pregnancy. Methodological quality and quality of the publication/reporting of each SR were assessed by the application of AMSTAR (Assessing the Methodological Quality of Systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), respectively. Results The initial search retrieved 11 492 records, of which 16 SRs met our inclusion criteria. The average AMSTAR score was 7.3, the lowest score being 3 and the highest 11. The lowest PRISMA score was 12, the highest 25, and the average PRISMA score was 19.9. The results support the proposal that acupuncture might be considered an option for alleviating pain during labour, for correcting breech presentation, and for managing pelvic and back pain during pregnancy. There is insufficient evidence to recommend acupuncture for inducing labour, managing nausea and vomiting in early pregnancy, improving sleep quality, controlling nausea and vomiting associated with Caesarean delivery, and managing urinary infection. Conclusions Acupuncture might be an option for alleviating pain during labour, for correcting breech presentation, and for managing pelvic and back pain during pregnancy. More studies are needed to confirm the effects of acupuncture for other pregnancy-related acute conditions.

Sign in / Sign up

Export Citation Format

Share Document