Quality assessment of clinical practice guidelines in Kenya using the AGREE II tool: a methodological review

Sagam, Caleb Kimutai; Were, Lisa; Otieno, Jenifer Akoth; Mulaku, Mercy; Kariuki, Simon; Ochodo, Eleanor

doi:10.1136/bmjopen-2023-074510

Cited by 3 publications

(1 citation statement)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent methodological review by Sagam et al of Kenyan clinical guidelines using the AGREE II tool highlighted glaring gaps in the domain rigor of development, stakeholder involvement, applicability, and editorial independence (26). It included only one nutritional guideline which is not an adequate representation to generalize to the East African Community In addition, methodological quality was only assessed by the AGREE II tool.…”

Section: Introductionmentioning

confidence: 99%

Reporting and Methodological Quality of Clinical Practice Guidelines for Management of Malnutrition in the East African Community: A Systematic Review Protocol

Sagam,

Owino,

Were

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Clinical Practice Guidelines (CPGs), serve as a framework for healthcare professionals to support therapeutic decisions and best practices for optimising patient care. However, if the guidelines do not sufficiently address all the important components of optimal care, their quality, validity, and impact are reduced. Despite multiple interventions, cases of malnutrition are still high due to the several factors linked to them. Therefore, there is a need to establish the methodological quality of malnutrition CPGs. Objective: To review and critically appraise the methodological quality of CPGs in managing malnutrition within the East African Community (EAC). Methods: We intend to focus on Integrated Management of Acute Malnutrition (IMAM) and Community Integrated Management of Malnutrition (CIMAM) guidelines. We will also focus on guidelines written in English or French and published in the last five years from the last search date or the latest guideline available. We will search the Ministry of Health websites of the EAC countries: Tanzania, Kenya, Uganda, South Sudan, Burundi, Rwanda, and the Democratic Republic of Congo. We will also search Health associations of the respective countries and their e-repositories. Using Google Search Engine, we will use the search terms "clinical practice guidelines, "nutrition guidelines", "nutrition protocols", "health guidelines"," "IMAM", "CIMAM" and "country". Five reviewers will independently select CPGs and extract data in English and French guidelines. We will conduct a quality assessment using the online version of the AGREE II tool across six domains and using the RIGHT reporting checklist. Descriptive statistics will be analysed using STATA software version 17 (Stata Corp LLC, College TX).

show abstract

Section: Introductionmentioning

confidence: 99%

Reporting and Methodological Quality of Clinical Practice Guidelines for Management of Malnutrition in the East African Community: A Systematic Review Protocol

Sagam,

Owino,

Were

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Quality evaluation of French guidelines in primary care infectious disease: An AGREE II assessment

Akhamlich,

Gillet‐Lecourt,

Bouchard

et al. 2024

Evaluation Clinical Practice

View full text Add to dashboard Cite

RationaleAntibiotic prescription, its nature and its duration are a very common decision‐making situation in primary care practice. Clinical practice guidelines (CPGs) are regularly emitted by various organisations on this topic.Aims and objectivesOur goal is to run a quality appraisal of the current French guidelines, for the most common primary care infectious pathologies.MethodWe collected all primary care CPGs that are currently prevailing in France through a systematic review of the french website Antibioclic®. For each of these guidelines, a quality assessment was run by 3 independent reviewers, by means of the Appraisal of Guidelines for REsearch & Evaluation II instrument. The main outcome was a ‘reliability score’, defined as the sum of the scores in domains ‘rigour of development’ and ‘editorial independence’. To be considered ‘reliable’, the CPG had to reach a 60% threshold in these two domains. Secondary outcomes were as follows: global quality score of CPGs, number and ratio of CPGs for which a systematic review has been conducted during its conception.ResultsOver the 43 CPGs that have been assessed, none reached the 60%‐threshold as to the reliability score. Only one CPG (2.33%) gets an over‐60% quality assessment in the domain of rigour of development (D3), whereas three CPGs (6.98%) reach this threshold in the domain of editorial independence (D6). One CPG (2.33%) met the quality threshold of 60% as to overall assessment. Rigour of development and editorial independence are the domains that obtained the lowest average score, respectively, 11% and 21%. Overall assessment received an average score of 29%. A systematic review of the literature was mentioned for 10 CPGs (23.26%).ConclusionThere is a lack of quality in the development process of the current French guidelines in primary care infectiology. This process should be reconsidered, with higher insistence as to its quality.

show abstract

Quality assessment of clinical practice guidelines in Kenya using the AGREE II tool: a methodological review

et al. 2023

Self Cite

View full text Add to dashboard Cite

ObjectiveTo assess the quality of available and accessible national Clinical Practice Guidelines (CPGs) in Kenya using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.MethodsWe searched the websites of the Kenyan Ministry of Health, professional associations and contacted experts in relevant organisations. Our scope was guidelines on maternal, neonatal, nutritional disorders, injuries, communicable and non-communicable diseases in Kenya published in the last 5 years until 30 June 2022. Study selection and data extraction were done by three independent reviewers with disagreements resolved via discussion or with a senior reviewer. We conducted a quality assessment using the online English version of AGREE II tool across six domains. Descriptive statistics were analysed using Stata software V.17. The primary outcome was the methodological quality of the included CPGs assessed by the AGREE II tool score.ResultsWe retrieved 95 CPGs and included 24 in the analysis after screening for eligibility. The CPGs scored best in clarity of presentation and least in the rigour of development. In descending order, the appraisal scores (mean and CI) per domain were as follows: Clarity of presentation 82.96% (95% CI 78.35% to 87.57%) with all guidelines scoring above 50%. Scope and purpose 61.75% (95% CI 54.19% to 69.31%) with seven guidelines scoring less than 50%. Stakeholder involvement 45.25% (95% CI 40.01% to 50.49%) with 16 CPGs scoring less than 50%. Applicability domain 19.88% (95% CI 13.32% to 26.43%) with only one CPG scoring above 50%. Editorial independence 6.92% (95% CI 3.47% to 10.37%) with no CPG scoring above 50% and rigour of development 3% (95% CI 0.61% to 5.39%) with no CPG scoring at least 50%.ConclusionOur findings suggest that the quality of CPGs in Kenya is limited mainly by the rigour of development, editorial independence, applicability and stakeholder involvement. Training initiatives on evidence-based methodology among guideline developers are needed to improve the overall quality of CPGs for better patient care.

show abstract

Quality assessment of clinical practice guidelines in Kenya using the AGREE II tool: a methodological review

Cited by 3 publications

References 35 publications

Reporting and Methodological Quality of Clinical Practice Guidelines for Management of Malnutrition in the East African Community: A Systematic Review Protocol

Reporting and Methodological Quality of Clinical Practice Guidelines for Management of Malnutrition in the East African Community: A Systematic Review Protocol

Quality evaluation of French guidelines in primary care infectious disease: An AGREE II assessment

Quality assessment of clinical practice guidelines in Kenya using the AGREE II tool: a methodological review

Contact Info

Product

Resources

About