Assessing the Quality of Clinical Practice Guidelines in the Middle East and North Africa (MENA) Region: A Systematic Review

The current review aims to investigate the barriers to and facilitators of the adherence to clinical practice guidelines (CPGs) in the Middle East and North Africa (MENA) region. English language studies published between January 2010 and May 2019 were searched on PubMed, Embase, and EBSCO. The barriers were categorized as clinician-related factors, such as lack of awareness of familiarity with the CPGs, and external factors, such as patients, guidelines, and environmental factors. The search identified 295 titles, out of which 15 were included. Environmental factors, specifically lack of time, resources, incentives, availability, and costs of treatment or diagnostic tests, training, and dissemination plans were the most commonly identified barriers. The familiarity with or awareness of healthcare professionals about the guideline, guideline characteristics, lack of agreement with the guidelines and preference in clinical judgment, physician self-efficacy, and motivation were reported to a lesser extent. Few studies reported on the compliance of facilitators with the guidelines including disseminating and advertising guideline materials, education and training on the guidelines, regulatory and financial incentives, and support from institutions. The review highlights that the studies on barriers to and facilitators of compliance with CPGs in the MENA region are limited in number and quality.

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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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Systematic review of clinical practice guidelines for adults with fractures: identification of best evidence for rehabilitation to develop the WHO’s Package of Interventions for Rehabilitation

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-020-00560-w ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Francesca Gimigliano ◽

◽

Sara Liguori ◽

Antimo Moretti ◽

Giuseppe Toro ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Hip Fracture ◽

Distal Radius ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Adult Population ◽

World Health ◽

The World

Abstract Background The identification of existing rehabilitation interventions and related evidence represents a crucial step along the development of the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR). The methods for such identification have been developed by the WHO Rehabilitation Programme and Cochrane Rehabilitation under the guidance of the WHO’s Guideline Review Committee secretariat. The aim of this paper is to report on the results of the systematic search for clinical practice guidelines (CPGs) relevant to the rehabilitation of adults with fractures and to present the current state of evidence available from the identified CPGs. Methods This paper is part of the Best Evidence for Rehabilitation (be4rehab) series, developed according to the methodology presented in the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR) introductory paper. It is a systematic review of existing CPGs on fractures in adult population published from 2009 to 2019. Results We identified 23 relevant CPGs after title and abstract screening. According to inclusion/exclusion criteria, we selected 13 CPGs. After checking for quality, publication time, multiprofessionality, and comprehensiveness, we finally included five CPGs dealing with rehabilitative management of fractures in adult population, two CPGs addressing treatment of distal radius fracture and three the treatment of femoral/hip fracture. Conclusion The selected CPGs on management of distal radius and femoral/hip fracture include few recommendations regarding rehabilitation, with overall low to very low quality of evidence and weak/conditional strength of recommendation. Moreover, several gaps in specific rehabilitative topics occur. Further high-quality trials are required to upgrade the quality of the available evidence. Level of evidence Level 1.

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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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