Quality appraisal of clinical practice guidelines on the treatment of hepatocellular carcinoma or metastatic liver cancer: a systematic review

Article type
Authors
Wang Y1, Li YP1, Deng S2, Wei S3, Luo Q4, Li XL1, Yu J1
1The Chinese Cochrane Centre, China
2West China Hospital, Sichuan University, China
3West China Medical School, Sichuan University, China
4National Chengdu Center for Safety Evaluation of Drugs, West China Hospital, Sichuan University, China
Abstract
Objectives: This study was supported by Ministry of Science and Technology of China to quality appraisal the current available clinical practice guidelines (CPGs) for hepatocellular carcinoma (HCC) and sum recommendations of strongly recommended guidelines, so as to provide a policy-making evidence for clinical practice.

Methods: The databases of MEDLINE, Web of science, CBM and CNKI and the relevant CPGs websites were systematically searched until August 2012. The quality of CPGs was appraised by AGREE II instrument, and data and graphics were performed by SPSS 13.0 and SigmaPlot 12.0, respectively.

Results: Total 19 evidence-based guidelines and 10 expert consensuses were included. The mean percentage of six domains score of clarity of presentation, scope and purpose, stakeholder involvement, rigor of development, editorial independence and applicability were 89%, 84%, 64%, 49%, 37% and 20% respectively. The two domains of rigor of development and clarity of presentation in evidence-based guidelines were superior to expert consensus (p < 0.05).We finally strongly recommended and recommended five and nineteen guidelines, respectively. However, five guidelines were not recommended due to poor quality.

Conclusions: The overall methodological quality of CPGs for HCC is moderate, but with poor applicability and potential conflict of interest. The quality of evidence-based guidelines are significantly superior to consensus; however, it is also need to further increase the transparency of quality appraisal of evidence, recommended process and the involved conflict of interest.