AGREEing on Nutritional Management of Patients with CKD—A Quality Appraisal of the Available Guidelines

Bakaloudi, Dimitra Rafailia; Chrysoula, Lydia; Poulia, Kalliopi-Anna; Dounousi, Evangelia; Liakopoulos, Vassilios; Chourdakis, Michael

doi:10.3390/nu13020624

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…The AGREE II manual does not offer any advice on how to explain the scores. In accordance with previous studies (15,16), if a CPG scored above 70% on six domains, it was classified as 'high quality'; if a CPG scored above 70% on three to five domains, it was classified as 'moderate quality'; and if a CPG scored less than 70% on ≥ two domains, it was classified as 'low quality' .…”

Section: Quality Assessmentsupporting

confidence: 83%

Quality appraisal of clinical practice guidelines for the management of Dysphagia after acute stroke

Gao,

Liu,

Han

et al. 2023

Front. Neurol.

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ObjectivesDysphagia is a common complication in stroke patients, widely affecting recovery and quality of life after stroke. The objective of this systematic review is to identify the gaps that between evidence and practice by critically assessing the quality of clinical practice guidelines (CPGs) for management of dysphagia in stroke.MethodsWe systematically searched academic databases and guideline repositories between January 1, 2014, and August 1, 2023. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used by two authors to independently assess CPG quality.ResultsIn a total of 14 CPGs included, we identified that three CPGs obtained a final evaluation of “high quality,” nine CPGs achieved “moderate quality” and two CPGs received “low quality.” The domain of “scope and purpose” achieved the highest mean score (91.1%) and the highest median (IQR) of 91.7% (86.1, 94.4%), while the domain of “applicability” received the lowest mean score (55.8%) and the lowest median (IQR) of 55.4% (43.2, 75.5%).ConclusionThe CPG development group should pay more attention to improving the methodological quality according to the AGREE II instrument, especially in the domain of “applicability” and “stakeholder involvement;” and each item should be refined as much as possible.

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Section: Quality Assessmentsupporting

confidence: 83%

Quality appraisal of clinical practice guidelines for the management of Dysphagia after acute stroke

Gao,

Liu,

Han

et al. 2023

Front. Neurol.

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“…According to the calculation formula, the scores in each domain were calculated and the calculation formula was as follows: each domain score = (obtained score – minimum possible score)/ (maximum possible score – minimum possible score) × 100%. Consistent with a previous study ( 28 ), the score of a domain or overall rating ≤ 40% was considered as a low rating, >40 and ≤ 70% as a moderate rating, and > 70% as a high rating.…”

Section: Methodsmentioning

confidence: 81%

Quality appraisal of clinical practice guidelines for motor neuron diseases or related disorders using the AGREE II instrument

Liu

et al. 2023

Front. Neurol.

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ObjectivesThis study aimed to systematically assess the quality of CPGs for motor neuron diseases (MNDs) or related disorders and identify the gaps that limit evidence-based practice.MethodsFour scientific databases and six guideline repositories were searched for eligible CPGs. Three researchers assessed the eligible CPGs using the Appraisal of Guidelines Research and Evaluation II instrument. The distribution of the level of evidence and strength of recommendation of these CPGs were determined. The univariate regression analysis was used to explore the characteristic factors affecting the quality of CPGs.ResultsFifteen CPGs met the eligibility criteria: 10 were for MND and 5 were for spinal muscular atrophy. The mean overall rating score was 44.5%, and only 3 of 15 CPGs were of high quality. The domains that achieved low mean scores were applicability (24.4%), rigor of development (39.9%), and stakeholder involvement (40.3%). Most recommendations were based on low-quality evidence and had a weak strength. The CPGs that were updated, meant for adults, and evidence based, and used a CPG quality tool and a grading system were associated with higher scores in certain specific domains and overall rating.ConclusionThe overall quality of CPGs for MNDs or related disorders was poor and recommendations were largely based on low-quality evidence. Many areas still need improvement to develop high-quality CPGs, and the use of CPG quality tools should be emphasized. A great deal of research on MNDs or related disorders is still needed to fill the large evidence gap.

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“…The authors also found that the nutritional care procedures recommended by different CPG varied greatly (8) . Recently, a quality appraisal review of eleven guidelines for the nutritional management of patients with chronic kidney disease showed that none of them presented high quality according to the AGREE II tool, while three presented moderate quality and were recommended with modifications by the reviewers (53) . To the best of our knowledge, no systematic review of nutrition CPG applied the AGREE-REX tool (11) .…”

Section: Quality Of Guidelines On Nutrition Care Processesmentioning

confidence: 99%

Quality appraisal of clinical nutrition practice guidelines for critically ill adult patients: a systematic review using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE-II) and AGREE-Recommendation Excellence (AGREE-REX)

Cattani¹,

Teixeira²,

Eckert³

et al. 2022

Br J Nutr

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Nutritional therapy should follow evidence-based practice, thus several societies regarding nutrition and critical care have developed specific Clinical Practice Guidelines (CPG). However, to be regarded as trustworthy the quality of the CPG for critically ill patients and its recommendations need to be high. This systematic review aimed to appraise the methodology and recommendations of nutrition CPGs for critically ill patients. We performed a systematic review (protocol number CRD42020184199) with literature search conducted on Pubmed, Embase, Cochrane Library, and other four specific databases of guidelines up to October 2021. Two reviewers, independently, assessed titles and abstracts and potentially eligible full text reports to determine eligibility and subsequently four reviewers appraised the guidelines quality using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE-II) and AGREE-Recommendation Excellence (AGREE-REX). Ten CPG for nutrition in critically ill patients were identified. Only Academy of Nutrition and Dietetics and European Society of Intensive Care Medicine had a total acceptable quality and were recommended for daily practice according AGREE-II. None of the CPG recommendations had an overall quality score above 70%, thus being classified as moderate quality according AGREE-REX. The methodological evaluation of the critically ill adult patient CPGs revealed significant discrepancies and showed a need for improvement in its development and/or reporting. In addition, recommendations about nutrition care process presented a moderate quality.

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AGREEing on Nutritional Management of Patients with CKD—A Quality Appraisal of the Available Guidelines

Cited by 7 publications

References 29 publications

Quality appraisal of clinical practice guidelines for the management of Dysphagia after acute stroke

Quality appraisal of clinical practice guidelines for the management of Dysphagia after acute stroke

Quality appraisal of clinical practice guidelines for motor neuron diseases or related disorders using the AGREE II instrument

Quality appraisal of clinical nutrition practice guidelines for critically ill adult patients: a systematic review using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE-II) and AGREE-Recommendation Excellence (AGREE-REX)

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