scholarly journals Revisão externa das Diretrizes da SBC segundo a ferramenta AGREE II - Precisamos rever nossas Diretrizes?

2022 ◽  
Vol 4 ◽  
pp. e3930
Author(s):  
Leonardo Castro Luna ◽  
Carlos Alberto Magliano ◽  
Renata Medina Dos Santos ◽  
Breno Macedo De Almeida ◽  
Antonio Fatorelli ◽  
...  
Keyword(s):  
Agree Ii

INTRODUÇÃO: Diretrizes Clínicas devem ser documentos elaborados de forma sistemática que visam em primeiro lugar apoiar com a melhor informação médica disponível a decisão de um paciente e de um profissional de saúde. Adicionalmente também podem ser utilizadas pelo gestor para a formulação de políticas públicas. OBJETIVO: Avaliar a qualidade metodológica de 3 Diretrizes Clínicas da Sociedade Brasileira de Cardiologia (SBC) segundo uma ferramenta aceita internacionalmente para esta finalidade, e sugerir melhorias na elaboração deste tipo de documento. MÉTODOS: 12 avaliadores independentes (4 por documento) utilizaram a ferramenta AGREE II para avaliar metodologicamente três Diretrizes Clínicas da SBC que abordam assuntos de extrema importância e prevalência na população mundial: Hipertensão Arterial, Diabetes e Dislipidemia. RESULTADOS: Segundo a avaliação das 3 Diretrizes, pelos baixos escores recebidos principalmente nos domínios de Envolvimento das Partes Interessadas, Aplicabilidade da Diretriz e em especial no Rigor do Desenvolvimento, 2 delas foram consideradas com uma metodologia de elaboração insatisfatória. CONCLUSÃO: A qualidade metodológica das Diretrizes Clínicas da SBC foi considerada insatisfatória. Sugerimos neste artigo estratégias para aprimorar o processo de elaboração de futuros documentos.

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 Integrating approaches for quality guideline development in LactaMap, an online lactation care support system

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melinda Boss ◽  
Jennifer Turner ◽  
Patrick Boss ◽  
Peter Hartmann ◽  
Douglas Pritchard ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Support System ◽  
Practice Guidelines ◽  
Common Sense ◽  
Guideline Development ◽  
Phase 1 ◽  
Domain Score ◽  
Agree Ii ◽  
Care Support

Abstract Background Health professionals caring for women and infants experiencing difficulty with breastfeeding have reported deficiencies in evidence-based lactation knowledge. LactaMap is an online lactation care support system with more than 100 clinical practice guidelines to support breastfeeding care. Clinical practice guidelines support medical decision-making by summarising scientific evidence into systematically developed statements for specific clinical circumstances. Both common-sense and theory-based approaches have been used for guideline development and debate continues regarding which is superior. LactaMap clinical practice guidelines were created over the course of 5 years using a common-sense approach that was refined inductively. The aim of this study was to incorporate a theory-based framework approach into the methodology for ongoing update and review of LactaMap clinical practice guidelines. Methods The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was chosen as the framework-based approach to appraise LactaMap guideline quality. The study was conducted in two phases. The first phase appraised all 103 original LactaMap guidelines. The second phase appraised a subset of 15 updated LactaMap guidelines using improved methodology guided by phase 1, as well as 15 corresponding original (un-updated) guidelines. Results Mean Domain scores for 103 LactaMap original guidelines were above 75% in 3 of the 6 AGREE II quality Domains and no mean Domain score rated poorly. Update of guideline methodology was guided by phase 1 appraisals. Improved documentation of methods relating to questions in the Rigour of Development Domain resulted in improvement in mean Domain score from 39 to 72%. Conclusions This study showed that a theory-based approach to guideline development methodology can be readily integrated with a common-sense approach. Factors identified by AGREE II theory-based framework provided practical guidance for changes in methodology that were integrated prior to LactaMap website publication. Demonstration of high quality in LactaMap clinical practice guideline methodology ensures clinicians and the public can have trust that the content founded on them is robust, scientific and of highest possible quality.

scholarly journals EAU, AUA and NICE Guidelines on Surgical and Minimally Invasive Treatment of Benign Prostate Hyperplasia: A Critical Appraisal of the Guidelines Using the AGREE-II Tool

2021 ◽  
pp. 1-10
Author(s):  
Dmitry Enikeev ◽  
Vincent Misrai ◽  
Enrique Rijo ◽  
Roman Sukhanov ◽  
Denis Chinenov ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Treatment Options ◽  
Stakeholder Involvement ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Agree Ii ◽  
Prostate Hyperplasia ◽  
Assessment Score ◽  
Nice Guideline ◽  
Agree Ii Tool

<b><i>Objective:</i></b> To critically appraise the methodological rigour of the clinical practice guidelines (CPGs) vis-à-vis BPH surgery as used by specialist research associations in the US, Europe and UK, and to compare whether the guidelines cover all or only some of the available treatments. <b><i>Methods:</i></b> The current guidelines issued by the EUA, AUA and NICE associations have been analyzed by 4 appraisers using the AGREE-II instrument. We also compared the recommendations given in the guidelines for surgical and minimally invasive treatment to find out which of these CPGs include most of the available treatment options. <b><i>Results:</i></b> According to the AGREE II tool, the median scores of domains were: domain 1 scope and purpose 66.7%, domain 2 stakeholder involvement 50.0%, domain 3 rigor of development 65.1%, domain 4 clarity of presentation 80.6%, domain 5 applicability 33.3%, domain 6 editorial independence 72.9%. The overall assessment according to AGREE II is 83.3%. The NICE guideline scored highest on 5 out of 6 domains and the highest overall assessment score (91.6%). The EAU guideline scored lowest on 4 out of 6 domains and has the lowest overall assessment score (79.1%). <b><i>Conclusions:</i></b> The analyzed CPGs comprehensively highlight the minimally invasive and surgical treatment options for BPH. According to the AGREE II tool, the domains for clarity of presentation and editorial independence received the highest scores. The stakeholder involvement and applicability domains were ranked as the lowest. Improving the CPG in these domains may help to improve the clinical utility and applicability of CPGs.

Evaluation of guidelines on the use of vaginal mesh implants for pelvic organ prolapse using the AGREE II instrument

2021 ◽  
Author(s):  
Sofia Tsiapakidou ◽  
Christiana Campani Nygaard ◽  
Janna Pape ◽  
Thais R Mattos Lourenço ◽  
Gabriele Falconi ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Agree Ii ◽  
Agree Ii Instrument

Interaction, Satisfaction, and the PCC

2021 ◽  
pp. 1-80
Author(s):  
Amy Rose Deal
Keyword(s):  
Special Interest ◽  
Dynamic Interaction ◽  
Agree Ii ◽  
Indirect Object ◽  
Syntactic Features ◽  
Testing Ground ◽  
Person Case Constraint ◽  
Satisfaction Theory ◽  
The Way

Abstract The person-case constraint (PCC) is a family of restrictions on the relative person of the two objects of a ditransitive. PCC effects offer a testing ground for theories of the Agree operation and of syntactic features, both those on nominals and (of special interest here) those found on agreement probes. In this paper, I offer a new theory of PCC effects in an interaction/satisfaction theory of Agree (Deal 2015a) and show the advantages of this framework in capturing PCC typology. On this model, probes are specified for interaction features, determining which features will be copied to them, and satisfaction features, determining which features will cause probing to stop. Applied to PCC, this theory (i) captures all four types of PCC effect recognized by Nevins (2007) under a unified notion of Agree; (ii) captures the restriction of PCC effects to contexts of “Double Weakness” in many prominent examples, e.g. in Italian, Greek, and Basque, where PCC effects hold only in cases where both the direct and indirect object are expressed with clitics; (iii) naturally extends to PCC effects in syntactic environments without visible clitics or agreement for one or both objects, as well as the absence of PCC effects in some languages with clitics or agreement for both the direct and indirect object. Two refinements of the interaction/satisfaction theory are offered. The first is a new notation for probes’ interaction and satisfaction specifications, clarifying the absence from this theory of uninterpretable/unvalued features as drivers of Agree. The second is a proposal for the way that probes’ behavior may change over the course of a derivation, dubbed dynamic interaction.

Development of an evidence-informed recommendation guide to facilitate physical activity counseling between oncology care providers and patients in Canada

2021 ◽  
Author(s):  
Angela J Fong ◽  
Catherine M Sabiston ◽  
Michelle B Nadler ◽  
Jonathan Sussman ◽  
Hugh Langley ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Physical Function ◽  
Sports Medicine ◽  
Development Process ◽  
Assessment Criteria ◽  
Care Providers ◽  
Agree Ii ◽  
Physical Activity Counseling ◽  
Oncology Care

Abstract Decision support aids help reduce decision conflict and are reported as acceptable by patients. Currently, an aid from the American College of Sports Medicine exists to help oncology care providers advise, assess, and refer patients to physical activity (PA). However, some limitations include the lack of specific resources and programs for referral, detailed PA, and physical function assessments and not being designed following an international gold standard (Appraisal of Guidelines for Research and Evaluation [AGREE] II). This study aimed to develop a recommendation guide to facilitate PA counseling by assessing the risk for PA-related adverse events and offering a referral to an appropriate recommendation. Recommendation guide development followed AGREE II, and an AGREE methodologist was consulted. Specifically, a stakeholder group of oncology care providers and cancer survivors were engaged to develop the assessment criteria for comorbidities, PA levels, and physical function. Assessment criteria were developed from published PA interventions, consultations with content experts, and targeted web-based searches for cancer-specific PA programs. Feedback on the recommendation guide was solicited from stakeholders and external reviewers with relevant knowledge and clinical experience. Independent AGREE methodologists appraised the development process. The recommendation guide is a five-page document, including a preamble, assessment criteria for absolute contraindications to PA, comorbidities, and PA/functional capacity with a list of appropriate resources. Independent AGREE methodologists rated the development process as strong and recommended the guide for use. The recommendation guide has the potential to facilitate PA counseling between oncology care providers and cancer survivors, thus, potentially impacting PA behavior.

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