scholarly journals Clinical Guidelines in Sports Medicine: Am I Reading a Guideline or a Consensus Statement: What’s the Difference? Does it Matter?

2015 ◽  
Author(s):  
Zuzana Machotka ◽  
Luke Perraton ◽  
Karen Grimmer
Keyword(s):  
Clinical Guidelines ◽  
Sports Medicine ◽  
Methodological Quality ◽  
Consensus Statement ◽  
Clinical Guideline ◽  
Impact Factors ◽  
Clinical Recommendations ◽  
Consensus Statements ◽  
Methodological Problems

Introduction: The integration of research evidence into clinical practice is one of the most challenging aspects of sports medicine. The time required to search library databases and read multiple systematic reviews represents a significant barrier to many clinicians. Clinical guidelines and consensus statements provide a summary of best practice for clinical conditions, and provide clinical recommendations. In sports medicine, the terms clinical guideline and consensus statement are often used interchangeably; however, important differences exist between these resources. The aims of this review were to identify the clinical guidelines published in key international sports medicine journals over the last five years, and assess their methodological quality. Methods: In March 2014, the top ten international sports medicine journals (identified on current impact factors) were searched using the single keyword ‘guideline’. Peer-reviewed papers providing clinical recommendations that were described by the authors as a guideline were included. The International Centre for Allied Health Evidence (iCAHE) guideline checklist, which consists of fourteen ‘yes’ and ‘no’ responses, graded 1 or 0 respectively, was used to assess the methodological quality of each clinical guideline. Results: Ten publications were retained from a pool of 34 potentially-relevant publications. The iCAHE guideline checklist scores ranged from 3 to 11 out of a possible 14. Within the ten included publications, the most frequently identified methodological problems were a failure to describe the strategy used to search for evidence, failure to critically appraise the quality of underlying evidence and failure to clearly link the hierarchy and quality of underlying evidence to each recommendation. Discussion: The ten sports medicine journals included in this review published few clinical guidelines, and these were of poor to moderate quality. These clinical guidelines should be interpreted with caution because of methodological problems identified by this review. Consensus statements are useful resources for busy sports medicine clinicians; however, these resources should be subjected to the same rigorous appraisal as clinical guidelines, in order to identify areas where bias may potentially limit the usefulness of the recommendations.

An Assessment of the Methodological Quality of Research Published in the American Journal of Sports Medicine

2005 ◽  
Vol 33 (12) ◽  
pp. 1812-1815 ◽  
Author(s):  
Robert H. Brophy ◽  
Michael J. Gardner ◽  
Omar Saleem ◽  
Robert G. Marx
Keyword(s):  
Data Collection ◽  
Sports Medicine ◽  
Methodological Quality ◽  
Case Series ◽  
Evidence Based ◽  
Prospective Data ◽  
Article Type ◽  
Based Medicine ◽  
Published Research

Background Evidence-based medicine has become a popular topic in academic medicine during the past several decades and more recently in orthopaedics and sports medicine. Hypothesis Articles published in The American Journal of Sports Medicine have shown an improvement in methodological quality in 2001-2003, compared with 1991-1993. Study Design Systematic review. Methods All articles published in The American Journal of Sports Medicine during the periods 1991-1993 and 2001-2003 were reviewed and classified by type of study. The use of pertinent methodologies such as prospective data collection, randomization, blinding, and controlled studies was noted for each article. The frequency of each article type and the use of evidence-based techniques were compared across study periods. Results Case series and descriptive studies decreased during the study period, from 27.4% to 15.3% (P=. 00003) and from 11.9% to 5.6% (P=. 001), respectively, of articles published. Prospective cohort studies increased from 4.7% to 14.1% (P=. 000005), and randomized, prospective clinical trials increased from 2.7% to 5.9% of articles (P=. 04). More studies tested an explicit hypothesis (P=. 0000002), used prospective data collection (P=. 000003), and used blinding (P=. 02), and more studies identified a funding source (P=. 004). Conclusions Overall, there was a shift toward more prospective and randomized research designs published in The American Journal of Sports Medicine during 2001-2003 compared to 1991-1993, demonstrating an improvement in the methodological quality of published research.

scholarly journals Assessing the methodological quality of clinical guidelines for preventing falls of patients

2016 ◽  
Vol 7 (4) ◽  
pp. 549-557
Author(s):  
Kamila Majkusová ◽  
Darja Jarošová ◽  
Renáta Zeleníková ◽  
Radka Kozáková
Keyword(s):  
Clinical Guidelines ◽  
Methodological Quality

scholarly journals Quality and Specific Concerns of Clinical Guidelines for Integrated Chinese and Western Medicine: A Critical Appraisal

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Xu Zhou ◽  
Sheng Xu ◽  
Qing Ren ◽  
Jianrong Chen
Keyword(s):  
Chinese Medicine ◽  
Clinical Guidelines ◽  
Western Medicine ◽  
Methodological Quality ◽  
Guideline Development ◽  
Intraclass Correlation ◽  
Biomedical Literature ◽  
China National Knowledge Infrastructure ◽  
Agree Ii

Objective. This study aimed to investigate the methodological quality of clinical guidelines (CGs) for integrated Chinese and Western medicine (ICWM) to inform clinical practice and guideline development. Methods. We searched PubMed, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data, VIP, five guideline databases, and four online book malls to identify ICWM CGs published up to January 11, 2019. Four independent appraisers assessed the quality of CGs using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and evaluated six specific concerns for ICWM. The standardized scores were calculated for the individual AGREE II domains. Results. Sixty-two ICWM CGs were included. The median standardized scores in the six domains of AGREE II were 65% in scope and purpose, 46% in clarity of presentation, 26% in applicability, 24% in stakeholder involvement, 15% in rigor of development, and 0% in editorial independence. The quality of ICWM CGs was significantly associated with the publication year (higher quality for CGs published after 2014) and the development method (higher quality for evidence-based CGs). Only one ICWM CG obtained a direct recommendation for use, and 14 could be recommended for use after modifications. The intra-appraiser consistency of the AGREE II appraisal was good (mean intraclass correlation coefficient range, 0.813–0.998). ICWM CGs also lacked a systematic search of ancient traditional Chinese medicine (TCM) classics (40.3%), conversion of TCM recommendations from ancient Chinese to the vernacular (14.5%), a discussion of interactions between TCM and Western medicine (27.4%), and rankings of different ICWM choices (0%). Conclusions. Although an improvement after 2014 occurred, the current 64 ICWM CGs are generally of poor methodological quality. Only 15 ICWM CGs can be recommended for use directly or with modifications. As the key distinctions from Western/Chinese medicine CGs, the ICWM-specific recommendations are also insufficient for the ICWM CGs, especially for interactions between TCM and Western medicine and rankings of different ICWM choices. Study Registration. This study has been registered at PROSPERO (no. CRD42018095767).

scholarly journals The methodological quality of clinical guidelines of the European Society of Human Reproduction and Embryology (ESHRE)

2008 ◽  
Vol 23 (8) ◽  
pp. 1786-1792 ◽  
Author(s):  
W.L.D.M. Nelen ◽  
R.W. van der Pluijm ◽  
R.P.M.G. Hermens ◽  
C. Bergh ◽  
P. de Sutter ◽  
...  
Keyword(s):  
European Society ◽  
Clinical Guidelines ◽  
Methodological Quality ◽  
Human Reproduction

scholarly journals Major Mistakes and Errors in the Use of Trial Sequential Analysis in Systematic Reviews or Meta-analyses – Protocol for a Systematic Review

2021 ◽  
Author(s):  
Christian Gunge Riberholt ◽  
Markus Harboe Olsen ◽  
Joachim Birch Milan ◽  
Christian Gluud
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Clinical Guidelines ◽  
Methodological Quality ◽  
Sequential Analysis ◽  
Trial Sequential Analysis ◽  
Type I ◽  
Research Waste ◽  
Meta Analyses

Abstract Background: Adequately conducted systematic reviews with meta-analyses are considered the highest level of evidence and thus directly defines many clinical guidelines. However, the risk of type I and II errors in meta-analyses are substantial. Trial Sequential Analysis is a method for controlling these risks. Erroneous use of the method might lead to research waste or misleading conclusions. Methods: The current protocol describes a systematic review aimed to identify common and major mistakes and errors in the use of Trial Sequential Analysis by evaluating published systematic reviews and meta-analyses that include this method. We plan to include all studies using Trial Sequential Analysis published from 2018 to 2021, an estimated 400 to 600 publications. We will search Medical Literature Analysis and Retrieval System Online (MEDLINE) and the Cochrane Database of Systematic Reviews (CDSR), including studies with all types of participants, interventions, and outcomes. The search will begin in July 2021. Two independent reviewers will screen titles and abstracts, include relevant full text articles, extract data from the studies into a predefined checklist, and evaluate the methodological quality of the study using the AMSTAR 2 (Assessing the methodological quality of systematic reviews). Discussion: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The identified mistakes and errors will form the basis of a reviewed guideline for the use of Trial Sequential Analysis. Appropriately controlling for type I and II errors might reduce research waste and improve quality and precision of the evidence that clinical guidelines are based upon.

scholarly journals Comparison of Content and Quality of Caribbean, International, and High-Income Country-Specific Clinical Guidelines for Managing Type 2 Diabetes Mellitus

2021 ◽  
Vol 18 (24) ◽  
pp. 12868
Author(s):  
Amy Latifah Nixon ◽  
Kaushik Chattopadhyay ◽  
Jo Leonardi-Bee
Keyword(s):  
Clinical Guidelines ◽  
Clinical Guideline ◽  
High Income ◽  
Income Country ◽  
High Income Country ◽  
Caribbean Region ◽  
High Quality ◽  
The Caribbean ◽  
Country Specific

Purpose. Type 2 diabetes mellitus (T2DM) is poorly managed in the Caribbean region; therefore, conducting an assessment on the content and quality of clinical guidelines could assist guideline developers in detecting and addressing information gaps. Hence, this study aimed to benchmark and compare the clinical guidelines for T2DM management from the Caribbean to guidelines developed internationally and by high-income countries. Methods. Seven T2DM management clinical guidelines were a priori selected from international and high-income country-specific clinical guidelines and then compared to the country-specific T2DM management clinical guidelines of the Caribbean region. Two reviewers independently assessed content (using a previously piloted data extraction form) and quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Results. The Caribbean clinical guideline was found to contain similar levels of T2DM management topics when compared to international and high-income country-specific clinical guidelines; however, one country-specific clinical guideline from New Zealand was found to have substantially lower levels of content. The clinical guideline from the Caribbean was found to be of low quality and could not be used in practice; however, only three comparator clinical guidelines were found to be of high quality and could be recommended for use in clinical practice. A further three comparator clinical guidelines could be used in practice with minor modifications. Conclusion. Although the T2DM management clinical guidelines from the Caribbean region contained high levels of content with regards to relevant topics, it was of insufficient quality to be used in clinical practice. Therefore, an alternative high-quality clinical guideline, as identified within this study, should be adopted and used within the Caribbean region to manage T2DM until a high-quality region-specific clinical guideline can be developed.

scholarly journals The Association Between Tobacco Outlet Density and Smoking Among Young People: A Systematic Methodological Review

2019 ◽  
Author(s):  
Paulien A W Nuyts ◽  
Lisa E M Davies ◽  
Anton E Kunst ◽  
Mirte A G Kuipers
Keyword(s):  
Young People ◽  
Methodological Quality ◽  
Smoking Behavior ◽  
Positive Association ◽  
Primary Sources ◽  
Positive Direction ◽  
Outlet Density ◽  
Methodological Problems ◽  
Exposure Measurements

Abstract Aim Evidence on the association between tobacco outlet density and proximity and smoking behavior among youth is inconsistent, which may be due to methodological problems in some studies. We assessed the association of outlet density or proximity with smoking behavior among young people while taking into account the methodological quality of studies. Methods MEDLINE, EMBASE, and Google Scholar were systematically searched for studies on the relationship between outlet density or proximity and smoking behavior among 12- to 25-year-olds, published between 1997 and 2017. Methodological quality of the included studies was evaluated independently by two reviewers. Results Twenty studies were included in the review. The quality assessment identified five primary sources of potential bias: overadjustment for mediators (problems identified in 14 studies), underadjustment for confounders (six studies), poor statistical model fit (four studies), selection bias (three studies), and misclassification of exposure measurements (eight studies). Four studies were of high methodological quality. In studies with relatively high quality, 10 associations were reported, of which seven were nonsignificant, two positive, and one negative. Similarly, the complete body of evidence demonstrated mostly nonsignificant associations, but a larger proportion of positive associations than negative. Conclusion Although there is some support for a positive direction, current literature does not provide consistent evidence for a positive association between outlet density and smoking among youth. This is not necessarily due to bias in specific studies, but more to fundamental challenges in study design and exposure measurements. These issues need to be addressed in future studies using more rigorous methods. Implications Our findings suggest that, although there is some evidence for a positive association, current scientific literature does not provide consistent support to claim an effect of tobacco outlet density or proximity on youth smoking. This underlines the need for more research with improved methodology. There is a need for quasiexperimental studies, in which the outlet density changes substantially, studies measuring the actual exposure of youth to tobacco outlets, and qualitative research on the mechanisms underlying any association.

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