Systematic evaluation of the diagnostic approach of inflammatory bowel disease guidelines

Xiao, Bing-He; Ma, Xudong; Lv, Jia-Jun; Yang, Ting; Liu, Xin-Jie; An, Li-Ya; Qi, Yanfei; Lu, Ming-Liang; Duan, Yong-Qing; Sun, Dingyong

doi:10.1111/ijcp.14365

Int J Clin Pract

2021

DOI: 10.1111/ijcp.14365

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Systematic evaluation of the diagnostic approach of inflammatory bowel disease guidelines

Bing-He Xiao

Xudong Ma

Jia-Jun Lv

et al.

Abstract: According to recent research, globally, over a million American and 2.5 million European have IBD, and even low-incidence countries and regions (Asia, the Middle East, South America) have shown an increasing incidence. 1,2 IBD patients suffer from disabilities and discrimination that affects work, study and life, jeopardizing their quality of life. 3 The clinical manifestations of inflammatory bowel disease generally lack specificity (eg, abdominal pain, fatigue, diarrhoea, rectal bleeding) and can include ext… Show more

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Cited by 4 publications

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Natural approaches for the management of ulcerative colitis: evidence of preclinical and clinical investigations

Subudhi,

Poonia,

Singh

et al. 2024

Nat. Prod. Bioprospect.

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Ulcerative colitis (UC) is a recurring autoimmune disorder characterized by persistent inflammation in the mucosal lining of the lower part of the large intestine. Conventional treatment options such as salicylates, corticosteroids, and immunosuppressants often come with severe side effects, limited bioavailability, and the development of drug resistance, which hampers their therapeutic effectiveness. Therefore, it is imperative to explore natural strategies as safe and alternative treatments for UC. Currently, around 40% of UC patients find relief through natural constituents, which can help reduce toxic side effects and maintain clinical remission. This review aims to provide a summary of both preclinical and clinical evidence supporting the efficacy of various natural substances in the prophylaxis of UC. These natural options include plant extracts, essential oils, nutraceuticals, and phytochemicals. Furthermore, we will delve into the potential mechanisms that underlie the protective and curative actions of these novel herbal agents. In summary, this review will explore the effectiveness of natural remedies for UC, shedding light on their preclinical and clinical findings and the mechanisms behind their therapeutic actions. These alternatives offer hope for improved treatment outcomes and reduced side effects for individuals suffering from this challenging autoimmune condition. Graphical Abstract

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Natural approaches for the management of ulcerative colitis: evidence of preclinical and clinical investigations

Subudhi,

Poonia,

Singh

et al. 2024

Nat. Prod. Bioprospect.

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Quality problems in clinical practice guidelines and guideline appraisal studies: Should we tolerate or eradicate?

Yang,

Dou,

Liu

et al. 2024

Evaluation Clinical Practice

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BackgroundAppraisal of Guidelines for Research and Evaluation (AGREE) II instrument have been widely used by scholars around the world to assess the methodological quality of clinical practice guidelines (CPGs). We sought to identify items or domains that are commonly scored low in the assessment, and to systematically review the issues that emerged when evaluators used the AGREE II tool for guideline quality assessment.MethodsA systematic search was conducted to identify articles published in medically relevant databases from 2022 to 2023 regarding the use of the AGREE II tool for the assessment of CPGs. We extracted six quality domains and overall quality assessment data of CPGs included in the literature, and processed the data using descriptive statistical analysis, difference analysis, regression analysis, and correlation analysis. A seven‐point Likert scale was used to assess the reporting quality of the included articles.Results151 relevant publications were identified, including 2081 guidelines published between 1990 and 2022. The results of the regression analysis showed a statistically significant impact of all domains on overall guideline quality (p < 0.001; R2 = 0.777). Domain 1, 2, 3, 4, and 6 scores differed significantly over time (p < 0.001) and were increasing. The score was good for Domain 4 (median 78.00 [IQR: 62.75–89.00]; mean 74.34 [SD 18.85]) and Domain 1 (median 78.00 [IQR: 61.00–90.00]; mean 73.57 [SD 21.12]). Scores were generic for Domain 6 (median 58.33 [IQR: 25.00–83.33]; mean 53.98 [SD 34.13]), Domain 2 (median 53.00 [IQR: 33.30–72.10]; mean 53.30 [SD 24.52]) and Domain 3 (median 51.00 [IQR: 26.02–73.00]; mean 50.44 [SD 27.19]). The score was poor for Domain 5 (median 36.20 [IQR: 20.20–58.32]; mean 40.21 [SD 24.90]). In addition, the quality evaluation results of the included articles showed that 33.1% were evaluated as low and 11.9% as very low.ConclusionsAGREE II tools have facilitated the development of methodological quality for CPGs. Although the quality of CPGs has improved over time, some general low‐quality problems still exist, and solving these problems will be an effective way for developers to upgrade the quality of guidelines. In addition, addressing critical issues in the evaluation of guidelines to present high‐quality study reports would be another way to guide guideline development.

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Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review

et al. 2022

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Background The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their methodological quality. Therefore, we aimed to systematically evaluate the quality of CPGs for the diagnosis and treatment of IBD using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Methods We identified CPGs by searching databases (MEDLINE - PubMed, EMBASE, CINAHL, LILACS) and other sources of gray literature on January 2022. We included guidelines with specific recommendations for the diagnosis and treatment of IBD and evaluated them with the AGREE II instrument to assess their methodological quality. Six independent reviewers assessed the quality of the guidelines and resolved conflicts by consensus. We assessed the degree of agreement using the intraclass correlation coefficient (ICC) and change in quality over time was appraised in two periods: from 2012 to 2017 and from 2018 to 2022. Results We analyzed and evaluated 26 CPGs that met the inclusion criteria. The overall agreement among reviewers was moderate (ICC: 0.74; 95% CI 0.36 - 0.89). The mean scores of the AGREE II domains were: “Scope and purpose” 84.51%, “Stakeholder involvement” 60.90%, “Rigor of development” 69.95%, “Clarity of presentation” 85.58%, “Applicability” 26.60%, and “Editorial independence” 62.02%. No changes in quality were found over time. Conclusions The quality of the CPGs evaluated was generally good, with a large majority of the assessed guidelines being “recommended” and “recommended with modifications”; despite this, there is still room for improvement, especially in terms of stakeholder involvement and applicability. Efforts to develop high quality CPGs for IBD need to be further optimized.

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Systematic evaluation of the diagnostic approach of inflammatory bowel disease guidelines

Cited by 4 publications

References 46 publications

Natural approaches for the management of ulcerative colitis: evidence of preclinical and clinical investigations

Natural approaches for the management of ulcerative colitis: evidence of preclinical and clinical investigations

Quality problems in clinical practice guidelines and guideline appraisal studies: Should we tolerate or eradicate?

Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review

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