The Evidence Mapping and Methodological Quality of Clinical Practice Guidelines of Diagnosis and Management for Spinal Pain: A Cross-Sectional Survey

Abstract Objectives: To systematically review clinical practice guidelines (CPGs) for treating spinal pain, to assess the quality of different CPGs, and finally to provide an evidence map for the specific explication of research trends and gaps.Method: We searched CPGs in PubMed, Embase, Web of Science, Guidelines International Network (GIN), National Health and Medical Research Council (NHMRC), Scottish Intercollegiate Guidelines Network (SIGN) and the National Institute for Health and Care Excellence (NICE). We extracted basic information, recommendations, methodological quality, and reporting quality of the CPGs. Four researchers independently evaluated the quality of the CPGs according to the Appraisal of Guidelines Research and Evaluation (AGREE II) and Reporting Items for Practice Guidelines in Healthcare (RIGHT). Results: We included 21 CPGs into our study. According to the AGREE II checklist, we found that the mean score was relatively high in four domains, namely, scope and purpose (78.39), stakeholder involvement (63.04), clarity of presentation (72.04), and rigor of development (61.25). However, the mean score of two domains (editorial independence and application) was relatively low. Among the seven domains of the RIGHT checklist, one field (basic information) had the highest reporting rate (86.61%), while another field (funding, declaration, and management of interest) obtained the lowest reporting rate (53.00%). Conclusion: Our study provided evidence mapping, which is a good tool to reduce research waste and facilitate the process of knowledge transfer. We found the mean score of the application of included CPGs was the lowest and most of CPGs didn’t consider patient preferences. Therefore, guideline makers should concentrate on patient preference and application in future guidelines. The results of our study can also be used to optimize the implementation of these recommendations and to improve the development of reliable CPGs for treating spinal pain.

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The Evidence Mapping and Methodological Quality of Clinical Practice Guidelines of Diagnosis and Management for Spinal Pain: A Cross-Sectional Study

10.21203/rs.3.rs-198513/v1 ◽

2021 ◽

Author(s):

Jin-Feng Huang ◽

Zongshi Qin ◽

Xuan-Qi Zheng ◽

Jia-Liang Lin ◽

Kai Zhang ◽

...

Keyword(s):

Clinical Practice ◽

Practice Guidelines ◽

Methodological Quality ◽

Spinal Pain ◽

Reporting Rate ◽

Basic Information ◽

Agree Ii ◽

Evidence Mapping ◽

The Mean

Abstract Objectives: To systematically review clinical practice guidelines (CPGs) for treating spinal pain, to assess the quality of different CPGs, and finally to provide an evidence map for the specific explication of research trends and gaps.Method: We searched CPGs in PubMed, Embase, Web of Science, Guidelines International Network (GIN), National Health and Medical Research Council (NHMRC), Scottish Intercollegiate Guidelines Network (SIGN) and the National Institute for Health and Care Excellence (NICE). We extracted basic information, recommendations, methodological quality, and reporting quality of the CPGs. Four researchers independently evaluated the quality of the CPGs according to the Appraisal of Guidelines Research and Evaluation (AGREE II) and Reporting Items for Practice Guidelines in Healthcare (RIGHT). Results: According to the AGREE II checklist, we found that the mean score was relatively high in four domains, namely, scope and purpose (78.39), stakeholder involvement (63.04), clarity of presentation (72.04), and rigor of development (61.25). However, the mean score of two domains (editorial independence and application) was relatively low. Among the seven domains of the RIGHT checklist, one field (basic information) had the highest reporting rate (86.61%), while another field (funding, declaration, and management of interest) obtained the lowest reporting rate (53.00%). Conclusion: Our study provided evidence mapping, which is a good tool to reduce research waste and facilitate the process of knowledge transfer. The results of our study can also be used to optimize the implementation of these recommendations and to improve the development of reliable CPGs for treating spinal pain.

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

BMJ Open ◽

10.1136/bmjopen-2018-027285 ◽

2019 ◽

Vol 9 (6) ◽

pp. e027285 ◽

Cited By ~ 2

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.

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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)

Gastroenterology & Hepatology Open Access ◽

10.15406/ghoa.2018.09.00299 ◽

2018 ◽

Vol 9 (2) ◽

Author(s):

Aldo Maruy Saito ◽

Julio César Herrera Rodríguez ◽

Raúl Rojas Galarza

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Acute Gastroenteritis ◽

Methodological Quality ◽

Research Evaluation ◽

Agree Ii

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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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Quality appraisal of clinical practice guidelines for diabetes mellitus published in China between 2007 and 2017 using the AGREE II instrument

BMJ Open ◽

10.1136/bmjopen-2018-022392 ◽

2019 ◽

Vol 9 (9) ◽

pp. e022392

Author(s):

Yuting Gao ◽

Jinjing Wang ◽

Xufei Luo ◽

Xiaoyang Song ◽

Lian Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Clinical Practice ◽

Correlation Coefficient ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Biomedical Literature ◽

Agree Ii ◽

The Mean ◽

Agree Ii Instrument

ObjectiveThe aim of this study was to systematically evaluate the quality of the clinical practice guidelines (CPGs) for diabetes mellitus published in China over the period of January 2007 to April 2017.MethodsWe searched the China National Knowledge Infrastructure, Chinese Biomedical Literature database, VIP database and WanFang databases and guideline websites for CPGs for diabetes mellitus published between January 2007 and April 2017 in China. Two reviewers independently screened the literature according to the inclusion and exclusion criteria and extracted data. We used the the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool (Canadian Institutes of Health Research, Ottawa, Canada) to evaluate the quality of the included guidelines, calculated the scores of each domain and evaluated the consistency among the assessors via use of the intragroup correlation coefficient. And then we compared the results with Chinese CPGs and international CPGs. We conducted a subgroup analysis based on different classification criteria and compared scores of each domain subgroup analyses.ResultsA total of 98 guidelines were identified. The correlation coefficient within the group was 0.93, suggesting that the consistency between the evaluators was good. The scores of the six domains of AGREE II were described in median (IQR) as follows: scope and purpose 53.7 (50.0–59.7), stakeholder involvement 31.5 (27.3–37.0), rigour of development 19.1 (15.3–22.2), clarity of presentation 59.3 (50.0–64.8), applicability 18.1 (13.9–25.7) and editorial independence 0.0 (0.0–0.0). The mean score in each domain of quality of Chinese diabetes CPGs was lower than that of CPGs published worldwide but higher than the mean score of Chinese guidelines of all topics. A funding source, the updated version, organisation and publishers of the guidelines and target fields are all the factors influencing the quality of CPGs to a certain degree.ConclusionsA large number of Chinese diabetes CPGs have been produced. Their quality remain unsatisfactorily low compared with CPGs worldwide, there is still room for improvement. Chinese guideline developers should pay more attention to the transparency of methodology, and use the AGREE II instrument to develop and report guidelines.

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Methodological quality of clinical practice guidelines with physical activity recommendations for people diagnosed with cancer: A systematic critical appraisal using the AGREE II tool

PLoS ONE ◽

10.1371/journal.pone.0214846 ◽

2019 ◽

Vol 14 (4) ◽

pp. e0214846 ◽

Cited By ~ 5

Author(s):

Shirin M. Shallwani ◽

Judy King ◽

Roanne Thomas ◽

Odette Thevenot ◽

Gino De Angelis ◽

...

Keyword(s):

Physical Activity ◽

Clinical Practice ◽

Practice Guidelines ◽

Methodological Quality ◽

Critical Appraisal ◽

Agree Ii ◽

Physical Activity Recommendations ◽

Activity Recommendations ◽

Agree Ii Tool

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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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