scholarly journals Protocol of an interdisciplinary consensus project aiming to develop an AGREE II extension for guidelines in surgery

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037107
Author(s):  
George A Antoniou ◽  
Dimitris Mavridis ◽  
Sofia Tsokani ◽  
Manuel López-Cano ◽  
Iván D Flórez ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Conflicts Of Interest ◽  
Guideline Development ◽  
Reporting Quality ◽  
Consensus Conference ◽  
Professional Staff ◽  
Delphi Panel ◽  
Agree Ii

IntroductionAppraisal of Guidelines for Research and Evaluation (AGREE II) is an instrument that informs development, reporting and assessment of clinical practice guidelines. Previous research has demonstrated the need for improvement in methodological and reporting quality of clinical practice guidelines specifically in surgery. We aimed to develop an AGREE II extension document for application in surgical guidelines.Methods and analysisWe have performed a structured literature review and assessment of guidelines in surgery using the AGREE II instrument. In exploratory analyses, we have identified factors associated with guideline quality. We have performed reliability and factor analyses to inform the development of an extension document. We will summarise this information and present it to a Delphi panel of stakeholders. We will perform iterative Delphi rounds and we will summarise the final results to develop the extension instrument in a dedicated consensus conference.Ethics and disseminationFunding bodies will not be involved in the development of the instrument. Research ethics committee and Health Research Authority approval was waived, since this is a professional staff study only and no duty of care lies with the National Health Service to any of the participants. Conflicts of interest, if any, will be addressed by reassigning functions or replacing participants with relevant conflicts. The results will be disseminated through publication in peer reviewed journals, the funders’ websites, social media and direct contact with guideline development organisations and peer-reviewed journals that publish guidelines.

scholarly journals Reporting quality evaluation of the stroke clinical practice guidelines: a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Shuya Lu ◽  
Xufei Luo ◽  
Xiaojia Ni ◽  
Haoxuan Li ◽  
Miaomiao Meng ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Conflicts Of Interest ◽  
Guideline Development ◽  
Reporting Quality ◽  
Reporting Rate ◽  
Secondary Outcome ◽  
The Right

Abstract Objectives To analyze the effectiveness and quality of stroke clinical practice guidelines (CPGs) published in recent years in order to guide future guideline developers to develop better guidelines. Participants No patient involved Method PubMed, China Biology Medicine (CBM), Wanfang, CNKI, and CPG-relevant websites were searched from January 2015 to December 2019 by two researchers independently. The RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist was used to assess the reporting quality in terms of domains and items. Then, a subgroup analysis of the results was performed. Primary and secondary outcome measures RIGHT checklist reporting rate Results A total of 66 CPGs were included. Twice as many CPGs were published internationally as were published in China. More than half were updated. Most CPGs are published in journals, developed by societies or associations, and were evidence-based grading. The average reporting rate for all included CPGs was 47.6%. Basic information got the highest (71.7% ± 19.7%) reporting rate, while review and quality assurance got the lowest (22.0% ± 24.6%). Then, a cluster analysis between countries, publishing channels, and institutions was performed. There were no statistically significant differences in the reporting quality on the CPGs between publishing countries (China vs. international), publishing channels (journals vs. websites), and institutions (associations vs. non-associations). Conclusions Current stroke CPGs reports are of low quality. We recommend that guideline developers improve the quality of reporting of key information and improve the management of conflicts of interest. We recommend that guideline developers consider the RIGHT checklist as an important tool for guideline development. Trial registration 10.17605/OSF.IO/PBWUX.

scholarly journals Integrating approaches for quality guideline development in LactaMap, an online lactation care support system

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melinda Boss ◽  
Jennifer Turner ◽  
Patrick Boss ◽  
Peter Hartmann ◽  
Douglas Pritchard ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Support System ◽  
Practice Guidelines ◽  
Common Sense ◽  
Guideline Development ◽  
Phase 1 ◽  
Domain Score ◽  
Agree Ii ◽  
Care Support

Abstract Background Health professionals caring for women and infants experiencing difficulty with breastfeeding have reported deficiencies in evidence-based lactation knowledge. LactaMap is an online lactation care support system with more than 100 clinical practice guidelines to support breastfeeding care. Clinical practice guidelines support medical decision-making by summarising scientific evidence into systematically developed statements for specific clinical circumstances. Both common-sense and theory-based approaches have been used for guideline development and debate continues regarding which is superior. LactaMap clinical practice guidelines were created over the course of 5 years using a common-sense approach that was refined inductively. The aim of this study was to incorporate a theory-based framework approach into the methodology for ongoing update and review of LactaMap clinical practice guidelines. Methods The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was chosen as the framework-based approach to appraise LactaMap guideline quality. The study was conducted in two phases. The first phase appraised all 103 original LactaMap guidelines. The second phase appraised a subset of 15 updated LactaMap guidelines using improved methodology guided by phase 1, as well as 15 corresponding original (un-updated) guidelines. Results Mean Domain scores for 103 LactaMap original guidelines were above 75% in 3 of the 6 AGREE II quality Domains and no mean Domain score rated poorly. Update of guideline methodology was guided by phase 1 appraisals. Improved documentation of methods relating to questions in the Rigour of Development Domain resulted in improvement in mean Domain score from 39 to 72%. Conclusions This study showed that a theory-based approach to guideline development methodology can be readily integrated with a common-sense approach. Factors identified by AGREE II theory-based framework provided practical guidance for changes in methodology that were integrated prior to LactaMap website publication. Demonstration of high quality in LactaMap clinical practice guideline methodology ensures clinicians and the public can have trust that the content founded on them is robust, scientific and of highest possible quality.

scholarly journals The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yosuke Hatakeyama ◽  
Kanako Seto ◽  
Rebeka Amin ◽  
Takefumi Kitazawa ◽  
Shigeru Fujita ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Conflicts Of Interest ◽  
Agree Ii ◽  
Domain 3 ◽  
Based Medicine ◽  
The Relationship

Abstract Background The Appraisal of Guidelines for Research & Evaluation (AGREE) II has been widely used to evaluate the quality of clinical practice guidelines (CPGs). While the relationship between the overall assessment of CPGs and scores of six domains were reported in previous studies, the relationship between items constituting these domains and the overall assessment has not been analyzed. This study aims to investigate the relationship between the score of each item and the overall assessment and identify items that could influence the overall assessment. Methods All Japanese CPGs developed using the evidence-based medicine method and published from 2011 to 2015 were used. They were independently evaluated by three appraisers using AGREE II. The evaluation results were analyzed using regression analysis to evaluate the influence of 6 domains and 23 items on the overall assessment. Results A total of 206 CPGs were obtained. All domains and all items except one were significantly correlated to the overall assessment. Regression analysis revealed that Domain 3 (Rigour of Development), Domain 4 (Clarity of Presentation), Domain 5 (Applicability), and Domain 6 (Editorial Independence) had influence on the overall assessment. Additionally, four items of AGREE II, clear selection of evidence (Item 8), specific/unambiguous recommendations (Item 15), advice/tools for implementing recommendations (Item 19), and conflicts of interest (Item 22), significantly influenced the overall assessment and explained 72.1% of the variance. Conclusions These four items may highlight the areas for improvement in developing CPGs.

scholarly journals Reporting Quality of Clinical Practice Guidelines Regarding Gout and Hyperuricemia According to the Right Checklist

2020 ◽  
Author(s):  
Can Wang ◽  
Xufei Luo ◽  
Maichao Li ◽  
Lingling Cui ◽  
Xinde Li ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Guideline Development ◽  
Reporting Quality ◽  
Reporting Rate ◽  
Biomedical Literature ◽  
China National Knowledge Infrastructure ◽  
The Right

Abstract Objectives The Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist was used to assess the reporting quality of 2009–2019 Clinical Practice Guidelines (CPGs) regarding gout and hyperuricemia, aimed to improve the reporting quality of future guidelines.Methods We searched PubMed, the Chinese Biomedical Literature database, the Wan Fang Database, and the China National Knowledge Infrastructure from January 2009 to June 2019 for relevant guidelines. We also searched the websites of guideline development organizations (the Guidelines International Network, the National Institute for Health and Clinical Excellence, the American College of Rheumatology, and the European League Against Rheumatism) (EULAR). Furthermore, supplementary guidelines reported in included articles were systematically searched, as well as Medlive and Google Scholar. Results Seventeen guidelines were included, of which one was in Chinese and 16 were in English. The mean reporting rate of the 35 items specified was 14.9 (42.5%), only five CPGs (29.4%) had a reporting rate >50%. Of the 35 items, three were very frequently reported. The reporting proportion of the seven domains (Basic information, Background, Evidence, Recommendations, Review and quality assurance, Funding and declaration and management of interests, and Other information) were 64.7%, 36.8%, 50.6% 50.6%, 42.9%, 8.82%, 33.8%, and 31.4%, respectively.Conclusion The reporting quality of the present guidelines for gout and hyperuricemia is relatively poor. We suggest that the RIGHT reporting checklist should be used by CPG developers to ensure higher reporting quality of future guidelines.

Author Financial Conflicts of Interest, Industry Funding, and Clinical Practice Guidelines for Anticancer Drugs

2015 ◽  
Vol 33 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Ariadna Tibau ◽  
Philippe L. Bedard ◽  
Amirrtha Srikanthan ◽  
Josee-Lyne Ethier ◽  
Francisco E. Vera-Badillo ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Conflicts Of Interest ◽  
Guideline Development ◽  
Industry Funding ◽  
Funding Sources ◽  
Consensus Statements ◽  
Financial Conflicts Of Interest ◽  
Based Medicine

Purpose Clinical practice guidelines (CPGs) and consensus statements (CSs) are used to apply evidence-based medicine or expert recommendations to clinical practice. Here we explore author financial conflicts of interest (FCOIs), sources of guideline funding, and their relationship with endorsement of specific drugs. Methods An electronic search of MEDLINE was conducted to identify CPGs and CSs for common solid cancers published between January 2003 and October 2013. The search was restricted to articles evaluating systemic therapy. We extracted data on self-reported author FCOIs, funding sources, use of manuscript writers, and endorsement of specific drugs in the abstract of the article. Results Of 142 articles evaluated, 64% were CPGs, and 36% were CSs. The proportion of articles reporting FCOIs improved from 11% in 2003 to 93% in 2013 (P for trend < .001). Only 45% of articles explicitly reported funding sources. Of these, 65% disclosed partial or full industry sponsorship. Use of manuscript writers was declared in 13%, but many articles did not explicitly report the role of authors in the writing of the manuscript. Endorsement of specific drugs was significantly associated with author FCOIs (odds ratio [OR], 7.29; P = .001), but not with industry funding (OR, 0.95; P = .37). Conclusion Reporting of FCOIs in CPGs and CSs has improved over time. Despite prevalent funding of guideline development by industry, such funding is not associated with endorsement of specific drugs. Author FCOIs are prevalent, and endorsement of a specific drug seems to be more common when authors have FCOIs with the pharmaceutical company marketing that drug.

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

2018 ◽  
Author(s):  
Cole Wayant ◽  
Craig Cooper ◽  
D’Arcy Turner ◽  
Matt Vassar
Keyword(s):  
Clinical Practice ◽  
Practice Guidelines ◽  
Conflicts Of Interest ◽  
Reporting Quality ◽  
Primary Objective ◽  
Agree Ii ◽  
Cross Sectional ◽  
Nccn Guidelines ◽  
The Right ◽  
Agree Ii Instrument

AbstractIntroductionRobust, 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, nor did they consistently describe the method for assessing the quality and certainty of evidence. 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 adherence to the RIGHT and AGREE II items. Doing so serves to improve the evidence delivered to healthcare providers, thus potentially improving patient care.

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

2019 ◽  
Vol 24 (6) ◽  
pp. 219-226 ◽  
Author(s):  
Cole Wayant ◽  
Craig Cooper ◽  
D’Arcy Turner ◽  
Matt Vassar
Keyword(s):  
Clinical Practice ◽  
Practice Guidelines ◽  
Conflicts Of Interest ◽  
Reporting Quality ◽  
Primary Objective ◽  
Agree Ii ◽  
Cross Sectional ◽  
Nccn Guidelines ◽  
The Right ◽  
Agree Ii Instrument

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.

scholarly journals Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040182
Author(s):  
Meng Zhang ◽  
Jun Tang ◽  
Yang He ◽  
Wenxing Li ◽  
Zhong Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Guideline Development ◽  
Neonatal Hyperbilirubinemia ◽  
Average Score ◽  
Agree Ii ◽  
Agree Ii Instrument

ObjectiveHyperbilirubinemia is one of the most common clinical symptoms in newborns. To improve patient outcomes, evidence-based and implementable guidelines are required. However, clinical guidelines may vary in quality, criteria and recommendations among regions and countries. In this study, we aimed to systematically assess the quality of guidelines using the Appraisal of Guidelines for Research & Evaluation (AGREE)-II instrument and summarise the specific recommendations for neonatal hyperbilirubinemia in order to provide suggestions for future guideline development.DesignSystematic review.InterventionsWe searched the PubMed, Embase, Medline and guideline databases for relevant articles on 10 April 2020. The studies were screened by two independent reviewers according to our inclusion criteria. Two reviewers independently extracted the descriptive data. Four appraisers assessed the guidelines using the AGREE-II instrument.ResultsOur systematic review appraised 12 clinical practice guidelines for the diagnosis and management of neonatal hyperbilirubinemia. The 12 guidelines achieved an average score of 36%–89%. The guidelines received the highest scores for clarity of presentation and lowest scores for rigour of development. Most recommendations for diagnosis were relatively consistent, but recommendations regarding risk factors, the initiating threshold of treatment and pharmacotherapy varied.ConclusionsOur study revealed that current guidelines vary in the quality of the developing process and are inconsistent with regards to recommendations. Future guidelines should afford more attention to the quality of methodologies in guideline development, and more qualified evidence is needed to standardise the initiating threshold of treatment for neonatal hyperbilirubinemia.

scholarly journals A review of the quality of current diabetes clinical practice guidelines

2017 ◽  
Vol 41 ◽  
pp. 1 ◽  
Author(s):  
Alberto Barcelo ◽  
Muzamil Jawed ◽  
Anthony Qiang ◽  
the PAHO Diabetes Guideline Project Group
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Guideline Development ◽  
Noncommunicable Diseases ◽  
Agree Ii ◽  
Quality Guidelines ◽  
The Mean ◽  
Health Organization ◽  
Almost All

Objective To obtain an evaluation of current type 2 diabetes mellitus (T2DM) clinical practice guidelines. Methods Relevant guidelines were identified through a systematic search of MEDLINE/PubMed. Pan American Health Organization (PAHO) country offices were also contacted to obtain national diabetes guidelines in use but not published/available online. Overall, 770 records were identified on MEDLINE/PubMed for citations published from 2008 to 2013. After an initial screening of these records, 146 were found to be guidelines related to diabetes. Inclusion and exclusion criteria were used to further refine the search and obtain a feasible number of guidelines for appraisal. Guideline evaluation was conducted by health professionals using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, which was developed to address the issue of variability in guideline quality and assesses the methodological rigor and transparency in which a guideline is developed. A total of 17 guidelines were selected and evaluated. Results Ten guidelines scored ≥ 70% and seven guidelines scored ≥ 80%. The range was 21%–100%. The mean scores for Latin America and the Caribbean (LAC) country guidelines (n = 6) were compared to the mean scores for non-LAC country guidelines (n = 11). International guidelines consistently scored notably higher in all domains and overall quality than LAC guidelines. Conclusions Based on this study’s findings, it is clear that T2DM clinical practice guideline development requires further improvements, particularly with regard to the involvement of stakeholders and editorial independence. This issue is most apparent for LAC country guidelines, as their quality requires major improvement in almost all aspects of the AGREE II criteria. Continued efforts should be made to generate and update high-quality guidelines to improve the management of increasingly prevalent noncommunicable diseases, such as T2DM.

scholarly journals Clinical practice guidelines and recommendations in the context of the COVID-19 pandemic: systematic review and critical appraisal

2020 ◽  
Author(s):  
Tanja A Stamm ◽  
Margaret R Andrews ◽  
Erika Mosor ◽  
Valentin Ritschl ◽  
Linda C Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Critical Appraisal ◽  
Guideline Development ◽  
Evaluation Instrument ◽  
Agree Ii ◽  
Guidelines And Recommendations

AbstractBackgroundThe number of published clinical practice guidelines and recommendations related to SARS-CoV-2 infections causing COVID-19 has rapidly increased. However, insufficient consideration of appropriate methodologies in the guideline development could lead to misleading information, uncertainty among professionals, and potentially harmful actions for patients.PurposeRapid systematic review of clinical practice guidelines and recommendations in the context of COVID-19 to explore if basic methodological standards of guideline development have been met.Data sourcesMEDLINE [PubMed], CINAHL [Ebsco], Trip and manual search; from Feb 1st 2020 until April 27th 2020.Study selectionAll types of healthcare workers providing any kind of healthcare to any patient population in any setting.Data extractionAt least two reviewers independently extracted guideline characteristics, conducted critical appraisal according to The Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) and classified the guidelines using the Association of the Scientific Medical Societies (AWMF) Guidance Manual and Rules for Guideline Development. We plan six-month updates (living review).Data synthesisThere were 1342 titles screened and 188 guidelines included. The highest average AGREE II domain score was 89% for scope and purpose, the lowest for rigor of development (25%). Only eight guidelines (4%) were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality, S3 according to AWMF). Patients were only included in the development of one guideline. A process for regular updates was described in 27 guidelines (14%).LimitationsMethodological focus only.ConclusionsDespite clear scope, most publications fell short of basic methodological standards of guideline development. Future research should monitor the evolving methodological quality of the guidelines and their updates over time.Registration/PublicationThe protocol was published at www.researchgate.net, DOI: 10.13140/RG.2.2.21293.51689. Preliminary results are publicly available on medRxiv.

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