Methodological quality of clinical practice guidelines on probiotics in acute gastroenteritis in children using the appraisal of guidelines for research & evaluation II instrument (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.

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

Frontiers in Medicine ◽

10.3389/fmed.2021.630765 ◽

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.

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

PLoS ONE ◽

10.1371/journal.pone.0203328 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0203328 ◽

Cited By ~ 1

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

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

BMJ Open ◽

10.1136/bmjopen-2018-022445 ◽

2018 ◽

Vol 8 (9) ◽

pp. e022445 ◽

Cited By ~ 17

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.

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Clinical Epidemiology in China series. Paper 4: The reporting and methodological quality of Chinese clinical practice guidelines published between 2014 and 2018: A Systematic Review

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2021.08.013 ◽

2021 ◽

Author(s):

Qi Zhou ◽

Zijun Wang ◽

Qianling Shi ◽

Siya Zhao ◽

Yangqin Xun ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Methodological Quality ◽

Clinical Epidemiology ◽

China Series

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

PLoS ONE ◽

10.1371/journal.pone.0181927 ◽

2017 ◽

Vol 12 (8) ◽

pp. e0181927 ◽

Cited By ~ 4

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

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Methodological quality of systematic reviews used in clinical practice guidelines: focus on clinical imaging

Clinical and Translational Imaging ◽

10.1007/s40336-021-00433-0 ◽

2021 ◽

Author(s):

Qianrui Li ◽

Ling Li ◽

Rang Wang ◽

Kang Zou ◽

Rong Tian ◽

...

Keyword(s):

Clinical Practice ◽

Systematic Reviews ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Methodological Quality ◽

Clinical Imaging

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

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0174 ◽

2019 ◽

Vol 47 (3) ◽

pp. 262-269 ◽

Cited By ~ 6

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.

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Methodological quality of clinical practice guidelines for genetic testing in children

Medicine ◽

10.1097/md.0000000000018521 ◽

2019 ◽

Vol 98 (52) ◽

pp. e18521 ◽

Cited By ~ 1

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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Quality Appraisal of Acne Clinical Practice Guidelines, 2008–2013

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2014.13190 ◽

2014 ◽

Vol 18 (6) ◽

pp. 385-391 ◽

Cited By ~ 2

Author(s):

Christopher Kawala ◽

Dilan Fernando ◽

Jerry K.L. Tan

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Methodological Quality ◽

Acne Vulgaris ◽

Stakeholder Involvement ◽

Agree Ii ◽

Common Chronic Disease ◽

Treatment Information ◽

Threshold Score

Background: Acne vulgaris is a common chronic disease, and evidence-based clinical practice guidelines (CPGs) can provide credible treatment information. Method: A literature search for acne CPGs published between January 2008 and September 2013 was conducted. Two reviewers independently applied the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Methodological quality was evaluated by ranking in AGREE II domains and the highest number of items scoring above the neutral threshold score. Results: Four CPGs fulfilled the selection criteria, and the highest ranked were the European and Malaysian. Highest scores achieved by the former were for scope/purpose, stakeholder involvement, and rigor of development and by the latter were for scope/purpose, clarity of presentation, and applicability. Applicability was the lowest scoring of all domains for all CPGs. Conclusion: European and Malaysian acne CPGs were ranked highest for methodological quality and may serve to inform clinical practice and guideline adaptation.

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