Analysis of Quality of Clinical Practice Guidelines for Otorhinolaryngology in China

Zhang, Zhewen; Liu, Xiaowen; Xu, Baicheng; Wang, Su‐Yang; Li, Li; Kang, Yingying; Guo, Yufen

doi:10.1371/journal.pone.0053566

Cited by 17 publications

(25 citation statements)

References 17 publications

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“…The finding of low scores for Croatian guidelines in most of AGREE domains (“Rigour of Development”, “Stakeholder Involvement”, “Applicability” and “Editorial Independence) is similar to the finding for other national guidelines, as recently published for the general population of guidelines and specific otorhinolaryngology guidelines in China [3], [4]. Like in China, Croatian guidelines have mostly been developed as expert opinions, which generally followed the methodology and presentation of a literary review, rather than methodologically rigorous analysis of evidence.…”

Section: Discussionsupporting

confidence: 79%

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Methodological Rigour and Transparency of Clinical Practice Guidelines Developed by Neurology Professional Societies in Croatia

2013

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BackgroundClinical practice guidelines are systematically created documents that summarize knowledge and assist in delivering high-quality medicine by identifying evidence that supports best clinical care. They are produced not only by international professional groups but also by local professionals to address locally-relevant clinical practice. We evaluated the methodological rigour and transparency of guideline development in neurology formulated by professionals in a local medical community.MethodsWe analyzed clinical guidelines in neurology publicly available at the web-site of the Physicians’ Assembly in Croatia in 2012: 6 guidelines developed by Croatian authors and 1 adapted from the European Federation of Neurological Societies. The quality was assessed by 2 independent evaluators using the AGREE II instrument. We also conducted a search of the Cochrane Library to identify potential changes in recommendation from Cochrane systematic reviews included in guideline preparation.ResultsThe methodological quality of the guidelines greatly varied across different domains. „Scope and Purpose” and „Clarity of Presentation“ domains received high scores (100% [95% confidence interval (CI) 98.5–100] and 97% [77.9–100], respectively), the lowest scores were in “Stakeholder Involvement“ (19% [15.5–34.6]) and “Editorial Independence” (0% [0–19.2]). Conclusions of 3 guidelines based on Cochrane systematic reviews were confirmed in updated versions and one update provided new information on the effectiveness of another antidepressant. Two Cochrane reviews used in guidelines were withdrawn and split into new reviews and their findings are now considered to be out of date.ConclusionNeurological guidelines used in Croatia differ in structure and their methodological quality. We recommend to national societies and professional groups to develop a more systematic and rigorous approach to the development of the guidelines, timely inclusion of best evidences and an effort to involve target users and patients in the guideline development procedures.

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Section: Discussionsupporting

confidence: 79%

“…They are produced not only by international organizations but also by professional associations in many countries, aiming to supply the local professionals with recommendations based on currently available evidence for best standard of care for the patients [2]–[4].…”

Section: Introductionmentioning

confidence: 99%

Methodological Rigour and Transparency of Clinical Practice Guidelines Developed by Neurology Professional Societies in Croatia

2013

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“…The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was initially developed in 2003, and updated to AGREE II in 2010. Consisting of 6 domains covering 23 key items [12] , it is an appraisal tool and validated instrument that has been endorsed by leading producers, raters and compilers of international CPGs to provide a framework for assessing their quality [13] . Previous studies have demonstrated that the quality of CPGs in different clinical areas was modest or variable [13] – [16] .…”

Section: Instructionmentioning

confidence: 99%

Evaluation of the Quality of Guidelines for Myasthenia Gravis with the AGREE II Instrument

Zhang

Guo

et al. 2014

PLoS ONE

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BackgroundClinical practice guidelines (CPGs) are systematically developed statements to assist practitioners in making decisions about appropriate healthcare in specific clinical circumstances. The methodological quality of CPGs for myasthenia gravis (MG) are unclear.ObjectiveTo critically evaluate the methodological quality of CPGs for MG using AGREE II instrument.MethodA systematical search strategy on PubMed, EMBASE, DynaMed, the National Guideline Clearinghouse (NGC) and the Chinese Biomedical Literature database (CBM) was performed on September 20th 2013. All guidelines related to MG were evaluated with AGREE II. The software used for analysis was SPSS 17.0.ResultsA total of 15 CPGs for MG met the inclusion criteria (12 CPGs in English, 3 CPGs in Chinese). The overall agreement among reviews was moderate or high (ICC >0.70). The mean scores (mean ± SD) for al six domains were presented as follows: scope and purpose (60.93% ±16.62%), stakeholder involvement (40.93% ±20.04%), rigor of development (37.22% ±30.46%), clarity of presentation (64.26% ±16.36%), applicability (28.19% ±20.56%) and editorial independence (27.78% ±28.28%). Compared with non-evidence-based CPGs, evidence-based CPGs had statistically significant higher quality scores for all AGREE II domains (P<0.05). All domain scores appear slightly higher for CPGs published after AGREE II instrument development and validation (P>0.05). The quality scores of CPGs developed by NGC/AAN were higher than the quality scores of CPGs developed by other organizations for all domains. The difference was statistically significant for all domains with the exception of clarity of presentation (P = 0.07).ConclusionsThe qualities of CPGs on MG were generally acceptable with several flaws. The AGREE II instrument should be adopted by guideline developers, particularly in China.

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“…Furthermore, as aggregate scoring across domains is not recommended by the AGREE Enterprise, the AGREE II Global Rating Scale (AGREE IIGRS) was used to rate overall quality on a 7point scale (from 1 = lowest quality to 7 = highest quality) and categorized as: "excellent quality"= score 7/7, "high quality" = 5-6/7, "moderate quality" = 4/7 and "poor quality" = 0-3/7. The AGREEII instrument is a validated appraisal tool for thorough quality assessment of guidelines and is widely used (18)(19)(20)(21)(22)(23)(24).…”

Section: Evaluation Of Included Clinical Practice Guidelinesmentioning

confidence: 99%

Clinical practice guidelines for the management of brain tumours: A rehabilitation perspective

Kim¹,

Novotná²,

Amatya³

et al. 2019

J Rehabil Med

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Brain tumours cause significant disability and morbidity. There are numerous published clinical practice guidelines (CPGs) for the management of brain tumours, and rehabilitation is recognized as an integral component of management of brain tumours. However, only limited numbers of these CPGs incorporate recommendations for specific rehabilitation interventions. To establish understanding of the issues of rehabilitation needs in brain tumours survivors, and synthesise evidence-based recommendations from rehabilitation perspective, published CPGs for brain tumours were critically appraised. Gaps in current literature were identified, and need of incorporation of rehabilitation interventions are highlighted. This is for future direction/recommendations in developing new CPGs to guide clinicians and to improve clinical outcomes in this population. Objective: To critically appraise published clinical practice guidelines (CPGs) for brain tumours, and to synthesize evidence-based recommendations from a rehabilitation perspective. Methods: A comprehensive literature search included: health science databases, CPG clearinghouse/ developer websites, and grey literature up to March 2018. All brain tumour CPGs that reported systematic methods for evidence search, and clearly defined recommendations supporting evidence for rehabilitation interventions were included. Three authors independently selected potential CPGs and assessed their methodological quality using the Appraisal of Guidelines, Research and Evaluation (AGREE-II) Instrument. Recommendations from included CPGs were categorized from a rehabilitation perspective. Results: Of the 11 CPGs identified, only 2, developed by the National Institute for Health and Clinical Excellence (NICE) and the Australian Cancer Network (ACN), included rehabilitation components for the management of brain tumours. Both CPGs were of moderate quality. The recommendations reported were generic, and only the ACN guidelines provided detailed recommendations for rehabilitation interventions. Both guidelines recommend a comprehensive multidisciplinary care approach. Detailed comparison, however, was not possible due to inconsistent recommendations, making it difficult to summarize rehabilitative care. Conclusion: Despite rehabilitation being an integral component of the management of brain tumours, only a limited number of CPGs have incorporated recommendations for specific rehabilitation interventions. In order to improve clinical outcomes in this population future CPGs should incorporate rehabilitation interventions.

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Analysis of Quality of Clinical Practice Guidelines for Otorhinolaryngology in China

Cited by 17 publications

References 17 publications

Methodological Rigour and Transparency of Clinical Practice Guidelines Developed by Neurology Professional Societies in Croatia

Methodological Rigour and Transparency of Clinical Practice Guidelines Developed by Neurology Professional Societies in Croatia

Evaluation of the Quality of Guidelines for Myasthenia Gravis with the AGREE II Instrument

Clinical practice guidelines for the management of brain tumours: A rehabilitation perspective

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