Article type
Year
Abstract
Background: Clinical practice guidelines (CPGs) play an important role in healthcare. The guideline development process should be precise and rigorous to ensure that the results are reproducible and not vague. To determine the quality of guidelines the Appraisal of Guidelines and Research and Evaluation (AGREE) instrument was developed and introduced.
Objectives: To assess the methodological quality of clinical practice guidelines for neurological disease on glioma.
Methods: Eight databases (included MEDLINE and EMBASE) were searched till to December, 2012. The methodological quality of the guidelines was assessed by two authors independently using the AGREEII instrument.
Results: From 940 citations, 15 relevant guidelines were included. The overall agreement among reviewers was moderate [ICC = 0.83; 95% confidence interval (CI), 0.66–0.92]. The mean scores were moderate for the domains ‘scope and purpose’ 60% and ‘clarity of presentation’ 65%, however there were low for the domains ‘‘stakeholder involvement’44%, ‘rigor of development’ 39%, ‘applicability’ 32%, ‘editorial independence’ 31%. Only 1/3 guidelines described the systematic methods for searching and selecting the evidence, nearly half of the 7(47%) guidelines didn’t give a specific recommondation. None described a procedure for updating the guideline. None used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
Conclusions: The quality and transparency of the development process and the consistency in the reporting of glioma guidelines need to be improved. The quality of reporting of guidelines was disappointing. Many other methodological disadvantages were identified. In the future, glioma CPGs should based on the best available evidence and rigorously developed and reported. The quality of glioma guidelines in China is low. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
Objectives: To assess the methodological quality of clinical practice guidelines for neurological disease on glioma.
Methods: Eight databases (included MEDLINE and EMBASE) were searched till to December, 2012. The methodological quality of the guidelines was assessed by two authors independently using the AGREEII instrument.
Results: From 940 citations, 15 relevant guidelines were included. The overall agreement among reviewers was moderate [ICC = 0.83; 95% confidence interval (CI), 0.66–0.92]. The mean scores were moderate for the domains ‘scope and purpose’ 60% and ‘clarity of presentation’ 65%, however there were low for the domains ‘‘stakeholder involvement’44%, ‘rigor of development’ 39%, ‘applicability’ 32%, ‘editorial independence’ 31%. Only 1/3 guidelines described the systematic methods for searching and selecting the evidence, nearly half of the 7(47%) guidelines didn’t give a specific recommondation. None described a procedure for updating the guideline. None used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
Conclusions: The quality and transparency of the development process and the consistency in the reporting of glioma guidelines need to be improved. The quality of reporting of guidelines was disappointing. Many other methodological disadvantages were identified. In the future, glioma CPGs should based on the best available evidence and rigorously developed and reported. The quality of glioma guidelines in China is low. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.