Quality appraisal of clinical guidelines and consensus statements on computed tomography for coronary artery disease

Article type
Authors
Yang P1, Yao D1, Tian JH1, Lei JQ1, Li JK1
1Evidence-Based Medicine Center of Lanzhou University, China
Abstract
Background: To improve diagnostic standardized and diagnostic accuracy on computed tomography (CT) for coronary artery disease (CAD). However, little is known about the methodological quality of these guidelines in CT for CAD.

Objectives: To evaluate the methodological quality of existing guidelines on CT for CAD according to the AGREE instrument, so as to regulate the development on CT for CAD guidelines and provide recommendations for these guidelines and consensuses.

Methods: Eight databases, three main websites of guideline and Google engines were searched for CAD on CT. Guidelines included were published by December 2012. The methodological quality of the guidelines and consensuses was assessed by one author independently using the AGREE II instrument.

Results: (a) 19 guidelines of CAD on CT were included for evaluation, Of 10 were consensuses, 9 were clinical guidelines; (b) the number of guidelines was increasing each year and reached a peak in 2010, 5 guidelines in 2010; (c) Table 1 shows that the stratification analysis of the AGREE II quality evaluation results on 6 domains of 9 clinical guidelines and 10 consensuses (10 guidelines were not recommendation, 2 guidelines were moderate recommendation, 7 guidelines were positive recommendation); (d) there were no any differences between more than 10 experts and less than 9 experts in clinical guidelines and consensuses (P > 0.05); (e) The quality of clinical guidelines was not obviously different with the quality of consensuses; (f) there were statistical differences between before the AGREE II released (≤ 2009 years) and after the AGREE II released (≥2010 years) on five domains besides the applicability domain of clinical guideline on CT for CAD (P < 0.05).

Conclusions: The quality and transparency of the guideline development process and the consistency in the reporting of CAD on CT guidelines need to be improved. The quality of reporting of guidelines was low.