AGREEing on Clinical Practice Guidelines for Autism Spectrum Disorders in Children: A Systematic Review and Quality Assessment

Abstract

Background: Autism spectrum disorder (ASD) is a multifaceted neurodevelopmental disorder requiring multimodal intervention and an army of multidisciplinary teams for a proper rehabilitation plan. Accordingly, multiple practice guidelines have been published for different disciplines. However, systematic evidence to detect and intervene must be updated regularly. Our main objective is to compare and summarize the recommendations made in the clinical practice guidelines (CPGs) for ASD in children released from November 2015 to March 2022. Methods: CPGs were subjected to a systematic review. We developed the inclusion and exclusion criteria and health-related questions, then searched and screened for CPGs utilizing bibliographic and CPG databases. Each of the CPGs used in the study were critically evaluated using the Appraisal of Guidelines for REsearch and Evaluation II (AGREE II) instrument. In a realistic comparison table, we summarized the recommendations. Results: Four eligible CPGs were appraised: Australian Autism CRC (ACRC); Ministry of Health New Zealand (NZ); National Institute of Clinical and Health Excellence (NICE); and Scottish Intercollegiate Guidelines Network, Healthcare Improvement Scotland (SIGN-HIS). The overall assessments of all four CPGs scored greater than 80%; these findings were consistent with the high scores in the six domains of AGREE II, including: (1) scope and purpose, (2) stakeholder involvement, (3) rigor of development, (4) clarity of presentation, (5) applicability, and (6) editorial independence domains. Domain (3) scored 84%, 93%, 86%, and 85%; domain (5) 92%, 89%, 54%, and 85%; and domain (6) 92%, 96%, 88%, and 92% for ACRC, NICE, NZ, and SIGN-HIS, respectively. Overall, there were no serious conflicts between the clinical recommendations of the four CPGs, but some were more comprehensive and elaborative than others. Conclusions: All four assessed evidence-based CPGs demonstrated high methodological quality and relevance for use in practice.

Saudi Expert Consensus-Based Autism Spectrum Disorder Statement: From Screening to Management

“…We elaborated further on the facilitation of activities and participation by helping the individual acquire new communication skills or modify existing skills in addition to the utilization of family-centered practice, which was not discussed in other international guidelines such as NICE and the Indian guidelines, which is another noted strength in our recommendations [ 17 , 28 , 29 ]. There are current efforts to draft the first national ASD Clinical Practice Guideline (ASD-CPG) using AGREE II Instrument and GRADE Method [ 34 ]. The new guideline will take time to develop, and we hope these recommendations will bridge the gap until it is released.…”

Autism Spectrum as an Etiologic Systemic Disorder: A Protocol for an Umbrella Review

“…The extreme relevance of all these validated therapies is undiscussable; however, they work mostly outside-oriented. Many international evidence-based clinical practice guideline programs have highlighted ASD as one of the top health priorities [ 32 ].…”

GC1f Vitamin D Binding Protein Isoform as a Marker of Severity in Autism Spectrum Disorders

“…Treatment of ASD is still a debated topic, and even existing guidelines provide different and sometimes conflicting suggestions [ 28 ]. It is, therefore, useful to try to identify severity markers, which can be used to differentiate patients not only in terms of the severity of the clinical presentation (as it is done in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) [ 1 ]) but also in the intensity of the rehabilitative treatment to be offered.…”