Clinical practice guidelines for the management of community‐acquired pneumonia: A critical appraisal using the AGREE II instrument

Triana, Abel; Molinares, Jorge L.; Rio‐Pertuz, Gaspar Del; Meza, Jose L.; Ariza‐Bolívar, Orlando; Robledo‐Solano, Andrea; Acosta‐Reyes, Jorge

doi:10.1111/ijcp.13478

Cited by 6 publications

(8 citation statements)

References 61 publications

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“…Therefore, this finding could be explained by either improvement in this area with more recent guidelines or more multidisciplinary collaboration across guidelines with pharmacotherapy recommendations. Other studies evaluating CPGs using the AGREE II instrument have generally found highest domain scores in the scope and purpose and clarity of presentation domain, and low scores in the applicability domain much as we have found here 3–9 …”

Section: Discussionsupporting

confidence: 78%

“…Previous AGREE II guideline assessments of acute care topics have identified lower scores in items related to stakeholder involvement, applicability and editorial independence, [3][4][5][6][7][8][9] while items related to rigor of development and editorial independence may have the greatest influence on overall perception of guideline quality. 10 A prior study using the AGREE II instrument to evaluate critical care CPGs (published through May 2017) found the lowest AGREE II domain scores exist in stakeholder involvement (Domain 2) and applicability (Domain 5).…”

mentioning

confidence: 88%

“…as we have found here. [3][4][5][6][7][8][9] It is well-established that despite the good availability of CPGs, the rate and amount of uptake of published evidence into practice is low. 19 Items included in practice guidelines that would lead to an increase in applicability domain scores are intended to help users apply guidelines recommendations and monitor or evaluate implementation of these recommendations.…”

Section: Subgroup Analysesmentioning

confidence: 99%

“…This AGREE II tool 2 is divided into six domains (1: scope and purpose, 2: stakeholder involvement, 3: rigor of development, 4: clarity of presentation, 5: applicability and 6: editorial independence) aimed at ensuring rigor and transparency in the development of CPGs. Previous AGREE II guideline assessments of acute care topics have identified lower scores in items related to stakeholder involvement, applicability and editorial independence, 3–9 while items related to rigor of development and editorial independence may have the greatest influence on overall perception of guideline quality 10 …”

Section: Introductionmentioning

confidence: 99%

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Use of the AGREE II instrument to evaluate critical care practice guidelines addressing pharmacotherapy

Linn

Beckett

Faust

2022

Evaluation Clinical Practice

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Rationale, Aims and Objectives Clinical practice guidelines (CPGs) have been evaluated for reporting transparency and methodological quality in a number of studies in various disciplines, but few studies have focused on critical care and none on pharmacotherapy‐related guidelines specifically. The objective of this study was to evaluate the quality of critical care CPGs with a focus on pharmacotherapy using the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument. Method A cross‐sectional study of CPGs published from 2013 through August 2021 was conducted. Following establishment of interrater reliability, guidelines were independently evaluated by three reviewers to rate guidelines on criteria set forth by the AGREE II instrument. Domain scores and item scores were calculated using the AGREE II user manual, and results described with descriptive statistics. Results Out of 192 guidelines identified, 73 met inclusion criteria and were screened using the AGREE II instrument. Most guidelines were authored by a professional organization or government agency. Domain quality scores were calculated for each domain as recommended by the AGREE II instrument. Domain 4 (clarity of presentation) had the highest AGREE II domain score with a median score of 87.0% (interquartile range: 79.6%−92.6%). Domain 5 (applicability) received the lowest domain score with a mean score of 41.8 ± 21.1%. The majority of guidelines were recommended for use as published or with modifications, while only six guidelines (8.2%) were not recommended for use. Conclusions The majority of critical care guidelines that include pharmacotherapy recommendations were recommended for use by study authors when the AGREE II instrument was applied. While guidelines generally scored highly in clarity of presentation, additional time and effort should focus on providing solutions to guideline implementation and inclusion of patient preferences.

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Section: Discussionsupporting

confidence: 78%

mentioning

confidence: 88%

Section: Subgroup Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of the AGREE II instrument to evaluate critical care practice guidelines addressing pharmacotherapy

Linn

Beckett

Faust

2022

Evaluation Clinical Practice

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“…This is consistent with several previous application of the AGREE II tool to CPGs across various specialties. 15,16,33 Six of the eleven guidelines omitted information about funding sources, and 7 of the eleven guidelines omitted information about potential conflicts of interest.…”

Section: Discussionmentioning

confidence: 99%

Clinical Practice Guidelines for the Management of Patients With Cleft Lip and Palate: A Systematic Quality Appraisal Using the Appraisal of Guidelines for Research and Evaluation II Instrument

Yver¹,

Chorath²,

Connolly

et al. 2021

Journal of Craniofacial Surgery

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Patients with cleft lip and/or palate require complex and longitudinal care by a multidisciplinary cleft team. Unfortunately, delivery of cleft care is often fragmented, and care practices can vary significantly. Multiple clinical practice guidelines (CPGs) have been proposed to provide a standardized framework for cleft care delivery. As CPGs have gained popularity, there has been increasing demand to maintain the quality of existing guidelines. A comprehensive search of EMBASE, MEDLINE via PubMed, Scopus, Cochrane and grey literature sources published from January 1, 1990 to December 31, 2020 was conducted to identify CPGs for the care of cleft patients. The Appraisal of Guidelines for Research and Evaluation, 2nd edition II tool was used to assess the quality of selected CPGs. Intraclass coefficients were calculated to assess agreement among appraisers. Eleven guidelines were identified for study inclusion. One guideline was classified as ''high'' quality by Appraisal of Guidelines for Research and Evaluation II criteria, and the remaining guidelines were classified as ''average'' or ''low'' quality. The ''Clarity of Presentation'' domain achieved the highest mean score (76.9% AE 11.7%) across CPGs, whereas the ''Rigor of Development'' domain scored the lowest (35.6% AE 21.2%). Intraclass coefficients analysis reflected very good inter-rater reliability across all domains (0.853-0.987). These findings highlight significant variability in the quality of existing CPGs for the global management of patients with cleft lip and/or palate. The ''Rigor of Development'' domain reflects the greatest opportunity for improvement. Given these findings, future guidelines may prioritize incorporating a systematic review of existing evidence into recommendations.

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Comparative Analysis of Clinical Practice Guidelines for the Pharmacological Treatment of Type 2 Diabetes Mellitus in Latin America

Restrepo¹,

Acosta‐Reyes

Estupiñan-Bohorquez

et al. 2023

Curr Diab Rep

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Purpose of Review Type 2 diabetes mellitus (T2DM) is one of the leading causes of death and disability in the world. The majority of diabetes deaths (> 80%) occur in low- and middle-income countries, which are predominant in Latin America. Therefore, the purpose of this article is to compare the clinical practice guideline (CPG) for the pharmacological management of T2DM in Latin America (LA) with international reference guidelines. Recent Findings Several LA countries have recently developed CPGs. However, the quality of these guidelines is unknown according to the AGREE II tool and taking as reference three CPGs of international impact: American Diabetes Association (ADA), European Diabetes Association (EASD), and Latin American Diabetes Association (ALAD). Summary Ten CPGs were selected for analysis. The ADA scored > 80% on the AGREE II domains and was selected as the main comparator. Eighty percent of LA CPGs were developed before 2018. Only one was not recommended (all domains < 60%). The CPGs in LA have good quality but are outdated. They have significant gaps compared to the reference. There is a need for improvement, as proposing updates every three years to maintain the best available clinical evidence in all guidelines.

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Clinical practice guidelines for the management of community‐acquired pneumonia: A critical appraisal using the AGREE II instrument

Cited by 6 publications

References 61 publications

Use of the AGREE II instrument to evaluate critical care practice guidelines addressing pharmacotherapy

Use of the AGREE II instrument to evaluate critical care practice guidelines addressing pharmacotherapy

Clinical Practice Guidelines for the Management of Patients With Cleft Lip and Palate: A Systematic Quality Appraisal Using the Appraisal of Guidelines for Research and Evaluation II Instrument

Comparative Analysis of Clinical Practice Guidelines for the Pharmacological Treatment of Type 2 Diabetes Mellitus in Latin America

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