Clinical practice guidelines: how they are produced in Poland

Article type
Year
Authors
Koperny M1, Blonska J1, Bala MM2
1Department of Public Health and Health Promotion, Province Sanitary Epidemiological Station, Krakow, Poland
2Cochrane Poland; Systematic Reviews Unit - Polish Cochrane Branch UJCM; Department of Hygiene and Dietetics UJCM, Poland
Abstract
Background: Clinical practice guidelines (CPG) provide physicians with recommendations on the management of their patients. They could be used to implement evidence-based clinical practice, but to do so, they should meet certain quality criteria.

Objectives: The aim of this project is to assess how CPG are produced in Poland and to assess their quality.

Methods: We searched medical databases and websites of medical societies to identify CPG produced by Polish medical societies in 2015 (not adapted or endorsed). We retrieved full texts of identified CPG and two reviewers assessed their validity independently. We used AGREE II instrument (The Appraisal of Guidelines for Research and Evaluation) to assess their quality. AGREE consists of 23 items organized within six domains (each item is rated on a 7-point scale: 1–strongly disagree to 7–strongly agree) and overall assessment rating. To analyse validity of documents we used a quality score algorithm recommended by AGREE. In addition we checked how many CPG cited Cochrane Reviews.

Results: We identified 15 CPG produced or updated in 2015. The highest mean score was obtained in domain 4 'clarity of presentation' 77%, meaning that the guidelines were mostly clearly presented and easily identifiable. The lowest result was obtained in domain 6 'editorial independence' - 14%, meaning that most of the guidelines did not provide information about funding and potential author conflicts of interest. The average quality score of an overall assessment was 54%. Domain 3, 'rigour of development', received mean score of 32%. Average total assessment of 15 guidelines was 4.27 points (range 2-6). Only three of the CPG cited Cochrane Reviews, and one of them was not the current version of the review.

Conclusions: Methodological quality of the 15 Polish CPG was moderate and varied, both between guidelines and within guidelines. The weakest elements in most of them included information about editorial independence and the identification, evaluation, and synthesis of the scientific evidence.