A critical appraisal of clinical practice guidelines on insomnia using the RIGHT statement and AGREE II instrument

Zhu, Hongfei; Li, Mengting; Pan, Bei; Yang, Qiuyu; Cao, Xiao; Wang, Qi; Chen, Yaolong; Ding, Guowu; Tian, Jinhui; Ge, Long

doi:10.1016/j.sleep.2022.08.023

Cited by 9 publications

(15 citation statements)

References 55 publications

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“…Three guidelines had significant flaws in methodology and completeness ( Figure 5 ). Adoption of such guidelines usually results in difficulties with standardization and adaptation of care in resource-limited settings ( 73 ), waste of medical resources ( 40 ), and even harm to patients ( 74 ). While the overall quality of the remaining seven reviewed guidelines reached acceptable levels, there is still much room for improvement.…”

Section: Discussionmentioning

confidence: 99%

“…Keeping guidelines updated is another challenge, as each step of searching for, synthesising, and appraising the evidence in order to make a graded recommendation is labor-intensive, time-consuming, and costly. Whereas, this process ensures that the up-to-date evidence is translated into accessible health outcomes in a timely manner ( 40 ). For CAM that mainstream clinicians do not specialize, it is even more critical to keep reflective of the sheer volume of the latest evidence in the guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…As clarified in a previous study, the quality rating score of a guideline cannot represent how it had affected clinical practice in the years following its publication ( 40 ). Guidelines graded as “recommended with modification” or “not recommended” in the bubble plot only refer to deficiencies in their development process and reporting information.…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines graded as “recommended with modification” or “not recommended” in the bubble plot only refer to deficiencies in their development process and reporting information. It should not be misinterpreted that the CAM recommendations comprised in these guidelines are with lower and weaker clinical practice value ( 40 ). We, therefore, suggest that in clinical practice CAM recommendations in high-quality guidelines be positively considered but be carefully implemented in combination with specific clinical settings; while CAM recommendations in low-quality guidelines not be repudiated outright, but be withheld for the time being and determined once more high-quality evidence is accumulated.…”

Section: Discussionmentioning

confidence: 99%

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Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines

Zhao,

Kennedy,

et al. 2023

Front. Psychiatry

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BackgroundClinical practice guidelines (CPGs) are used to guide decision-making, especially regarding complementary and alternative medicine (CAM) therapies that are unfamiliar to orthodox healthcare providers. This systematic review aimed to critically review and summarise CAM recommendations associated with anxiety management included in the existing CPGs.MethodsSeven databases, websites of six international guidelines developing institutions, and the National Centre for Complementary and Integrative Health website were systematically searched. Their reporting and methodological quality were evaluated using the Reporting Items for practice Guidelines in Healthcare checklist and the Appraisal of Guidelines for Research and Evaluation (2nd version) instrument, respectively.ResultsTen CPGs were included, with reporting rates between 51.4 and 88.6%. Seven of these were of moderate to high methodological quality. Seventeen CAM modalities were implicated, involving phytotherapeutics, mind–body practice, art therapy, and homeopathy. Applied relaxation was included in 70% CPGs, which varied in degree of support for its use in the treatment of generalised anxiety disorder. There were few recommendations for other therapies/products. Light therapy was not recommended for use in generalised anxiety disorder, and St John’s wort and mindfulness were not recommended for use in social anxiety disorder in individual guidelines. Recommendations for the applicability of other therapies/products for treating a specific anxiety disorder were commonly graded as “unclear, unambiguous, or uncertain”. No CAM recommendations were provided for separation anxiety disorder, specific phobia or selective mutism.ConclusionAvailable guidelines are limited in providing logically explained graded CAM recommendations for anxiety treatment and care. A lack of high-quality evidence and multidisciplinary consultation during the guideline development are two major reasons. High quality and reliable clinical evidence and the engagement of a range of interdisciplinary stakeholders are needed for future CPG development and updating.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022373694, identifier CRD42022373694.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines

Zhao,

Kennedy,

et al. 2023

Front. Psychiatry

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“…This has led to confusion among clinicians in selecting the appropriate guideline recommendations. Consequently, it's critical to recognize high-quality KOA CPGs 9,10 . There hasn't been much critical evaluation of the caliber of KOA's current CPGs up to this point.…”

Section: Introductionmentioning

confidence: 99%

Management of Knee OsteoArthritis(KOA) is improving:A scoping review and quality appraisal of Clinical Practice Guidelines for KOA using the AGREE II and RIGHT

Liu,

Wang,

et al. 2023

Preprint

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Background : Clinical practice guidelines (CPGs) are essential in healthcare, but their quality varies. This study aims to analyze 18 high-quality CPGs for knee osteoarthritis (KOA), identify areas for improvement, and establish common recommendations from contemporary CPGs for effective KOA management.Methods: We systematically searched guideline websites and databases until June 30, 2023, for KOA-related guidelines. Two independent reviewers assessed these using AGREE II and RIGHT checklists. The intra-class correlation coefficient (ICC) evaluated reviewer agreement, and recommendations and evidence levels were summarized.Results: We analyzed 18 Clinical Practice Guidelines (CPGs) from 1,411 records. Most were from China and the USA, published from 2016 to 2022, with 44.44% updates. Methodological quality was reliable, with 14 CPGs "recommended," but three had low "editorial independence" scores. Reporting quality ranged from 41.43–95.71%, with 66.66% scoring ≥ 80%. Recommendations included conservative measures, Tai Chi, Yoga, cane use, and various complementary and alternative medicines. Topical NSAIDs, oral NSAIDs, and intra-articular glucocorticoids were favored. Foreign guidelines stressed shared decision-making and patient preferences in KOA management.Conclusions: Over half of KOA CPGs are of good quality. However, there's substantial methodological variation and reporting quality gaps. Future efforts should enhance both. Our research supports a core set of interventions, including education, exercise, weight management, and personalized NSAID use, for evidence-based KOA practice and guideline development

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The Comparative Effectiveness and Safety of Insomnia Drugs: A Systematic Review and Network Meta-Analysis of 153 Randomized Trials

Pan

Lai

et al. 2023

Drugs

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A critical appraisal of clinical practice guidelines on insomnia using the RIGHT statement and AGREE II instrument

Cited by 9 publications

References 55 publications

Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines

Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines

Management of Knee OsteoArthritis(KOA) is improving:A scoping review and quality appraisal of Clinical Practice Guidelines for KOA using the AGREE II and RIGHT

The Comparative Effectiveness and Safety of Insomnia Drugs: A Systematic Review and Network Meta-Analysis of 153 Randomized Trials

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