The quality of clinical practice guidelines for chronic respiratory diseases and the reliability of the AGREE II: an observational study

Uzeloto, Juliana Souza; Moseley, Anne M.; Elkins, Mark R.; Franco, Márcia R.; Pinto, Rafael Zambelli; Freire, Ana Paula Coelho Figueira; Ramos, Ercy Mara Cípulo

doi:10.1016/j.physio.2016.11.002

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…The domains with the lowest quality appraisal scores were ‘rigour of development’ with an average score of 50.21% and ‘applicability’ with an average score of 45.05%. These findings are consistent with previous studies’ findings [ 37 – 39 ]. There was agreement on only six guidelines to be recommended for use without modifications [ 18 , 19 , 21 , 27 , 29 , 35 ], while 11 guidelines were recommended for use in practice with modifications [ 12 – 15 , 20 , 23 , 24 , 26 , 30 , 31 , 34 ].…”

Section: Discussionsupporting

confidence: 94%

Critical appraisal of tobacco dependence treatment guidelines

et al. 2020

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Background Tobacco use is a leading preventable cause of morbidity and mortality globally. Clinical practice guidelines for the treatment of tobacco use dependence are of varied scope and quality, making it challenging for users to select and apply recommendations. Objective The study objective is to identify and critically appraise the quality of existing clinical practice guidelines for tobacco cessation. Setting The study occurred between collaborative academic institutions located in Qatar and New Zealand. Methods A systematic literature search was performed for the period 2006–2018 through the following databases: PubMed, EMBASE, CINAHL, ISI Web of Science, Scopus, National Guideline Clearing House, Campbell Library, Health System Evidence, Joanna Briggs Institute Evidence-Based Practice Database, Academic Search Complete, ProQuest, PROSPERO, and Google Scholar. Relevant professional societies’ and health agencies’ websites were also searched. Two reviewers independently extracted and assessed guidelines’ quality using Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Main outcome measure Standardized domain scores according to the AGREE II instrument. Results 7741 hits were identified. After removing duplicates and screening, 24 guidelines were included. Highest guideline quality was for National Institute for Health and Care Excellence (NICE) guideline with an overall ranking score of 87.56% and least quality was for Japanese Circulation Society Joint Working Group with an overall score of 29.34%. Domain 4 of AGREE II (clarity of presentation) had the highest average quality score (70.95%), while the lowest average quality scores were for Domain 2 (Rigour of Development) (50.21%) and Domain 5 (Applicability) (45.05%). Conclusion Seven guidelines were judged to be of high quality (overall score of ≥ 70%). Future guidelines for tobacco dependence treatment should use rigorous methods of development and provide applicable recommendations.

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Section: Discussionsupporting

confidence: 94%

Critical appraisal of tobacco dependence treatment guidelines

et al. 2020

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“…The overall assessment of conformity between reviewers across each domain was calculated using the intra-class correlation coefficient (ICC) with 95% CIs (14). ICC that was 0.75 or higher was interpreted as excellent reliability, 0.40 to 0.75 as moderate reliability and less than 0.40 as poor reliability (15)(16)(17). Descriptive and statistical analyses were conducted using SPSS version 23.0 (IBM Corporation).…”

Section: Discussionmentioning

confidence: 99%

A quality assessment of evidence-based guidelines for the prevention and management of ventilator-associated pneumonia: a systematic review

Wan¹,

Liang²,

Yan³

et al. 2019

J. Thorac. Dis

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Background: Numerous evidence-based guidelines (EBGs) pertaining to ventilator-associated pneumonia (VAP) have been published by domestic and international organizations, but their qualities have not been reported. Methods: A systematic search of the literature was performed up to July 2018 for relevant guidelines. Guidelines were eligible for inclusion if they incorporated recommendation statements for prevention and/ or management in adults or children with VAP and were developed on a systematic evidence-based method. Four reviewers evaluated each guideline using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, which comprises 23 items organized into six domains in addition to two overall items. Results: Thirteen EBGs were identified for review. An overall high degree of agreement among reviewers was reached [intra-class correlation coefficient (ICC), 0.885; 95% CI, 0.862-0.905] during their review. The scores (mean, range) for the six AGREE domains were: scope and purpose (61%, 51-74%), stakeholder involvement (36%, 18-68%), rigor of development (41%, 22-59%), clarity and presentation (56%, 47-71%), applicability (38%, 21-59%) and editorial independence (50%, 0-77%). Only two EBGs (15.4%) were rated "recommended" for clinical practice. Approximately 86% of recommendations were based on moderate or low levels of evidence (levels B-D were 46.2%, 19.0%, and 21.2%, respectively). The recommendations for prevention and management of VAP were similar among the different EBGs. Conclusions: The overall quality of the identified EBGs pertaining to VAP was classified as moderate. The management of VAP varied by guideline. More high-quality evidence is needed to improve guideline recommendations.

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“…Nonetheless, compared with other CPGs scored with the AGREE-II instrument, those published by the NCCN appear to have as good or stronger methodological quality 11 13–15. A recent evaluation in JAMA Internal Medicine of CPGs for the pharmacological management of non-communicable diseases in primary care found that three CPG characteristics are associated with high-quality CPGs: greater than 20 authors, development at a government institution and reported funding 16.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the NCCN guidelines using the RIGHT Statement and AGREE-II instrument: a cross-sectional review

Wayant

Cooper

Turner

et al. 2019

BMJ EBM

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IntroductionRobust, clearly reported clinical practice guidelines (CPGs) are essential for evidence-based clinical practice. The Reporting Items for practice Guidelines in HealThcare (RIGHT) Statement and Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument were published to improve the methodological and reporting quality in healthcare CPGs.MethodsWe applied the RIGHT Statement checklist and AGREE-II instrument to 48 National Comprehensive Cancer Network (NCCN) guidelines. Our primary objective was to assess the adherence to RIGHT and AGREE-II items. Since neither RIGHT nor AGREE-II can judge the clinical usefulness of a guideline, our study is designed to only focus on the methodological and reporting quality of each guideline.ResultsThe NCCN guidelines demonstrated notable strengths and weaknesses. For example, RIGHT Statement items 19 (conflicts of interest), 7b (description of subgroups) and 13a (clear, precise recommendations) were fully reported in all guidelines. However, the guidelines inconsistently incorporated patient values and preferences and cost. Regarding the AGREE-II instrument, the NCCN guidelines scored highly on the domains 4 (clear, precise recommendations) and 6 (handling of conflicts of interest), but lowest on domain 2 (inclusion of all relevant stakeholders).ConclusionsIn this investigation, we found that NCCN CPGs demonstrate key strengths and weaknesses with respect to the reporting of key items essential to CPGs. We recommend the continued use of NCCN guidelines and improvements to weaknesses in reporting and methods. Doing so serves to improve the evidence delivered to healthcare providers, thus potentially improving patient care.

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The quality of clinical practice guidelines for chronic respiratory diseases and the reliability of the AGREE II: an observational study

Abstract: The quality of evidence-based clinical practice guidelines for chronic respiratory diseases relevant to physiotherapy could be improved, particularly in consideration with applicability. The number of assessors for AGREE II could be reduced because of the good inter-rater reliability.

Cited by 8 publications

References 23 publications

Critical appraisal of tobacco dependence treatment guidelines

Critical appraisal of tobacco dependence treatment guidelines

A quality assessment of evidence-based guidelines for the prevention and management of ventilator-associated pneumonia: a systematic review

Evaluation of the NCCN guidelines using the RIGHT Statement and AGREE-II instrument: a cross-sectional review

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