Development of a critical-appraisal tool for hospital clinical practice guideline in Cipto Mangunkusumo General Hospital, Indonesia

Article type
Authors
Harimurti K1, Saldi SRF1, Sulistyowati A1, Safitri ED1, Ranakusuma RW1, Pitoyo Y1, Wangge G1, Widyahening IS1, Kurniati N1, Soebadi A1, Nuryanto KH1, Setiati S1
1Clinical Epidemiology and Evidence-Based Medicine (CEEBM) Unit, Dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia
Abstract
Background: According to the Minister of Health’s decree concerning medical service standards, clinical practice guidelines (CPG) are one of the essential documents to guide healthcare service based on best-available scientific evidence. Throughout the years, a large number of hospital CPGs have been developed in Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Nevertheless, the quality of the CPGs is yet to be assessed.

Objectives: To develop a critical- appraisal tool that address the government’s requirement for hospital CPG.

Methods: An initial review of the existing appraisal tools was conducted to select the questions to be included in the critical-appraisal tool. Subsequently, a Delphi panel was established to build a consensus for the appraisal tool.

Results: According to MoH’s decree concerning medical service standards, hospital CPGs should comply with 5 domains, i.e. validity, systematic, evidence-based, updated, and clearly written. An initial list of 22 questions, of each was coherent with at least one of the abovementioned domains, was identified through the review of existing appraisal tools. A Delphi panel consisting of methodological and clinical experts was developed and went through two rounds of the Delphi process to refine the initial lists of questions. A consensus of the Delphi panel decided the final hospital CPG appraisal tool consisting of 14 questions.

Conclusions: A critical-appraisal tool addressing 5 important domains for hospital CPG has been developed to ensure the quality of CPGs in Cipto Mangunkusumo General Hospital. The tool can also be used as a guide when initiating CPGs development in the hospital.