Article type
Year
Abstract
Background: complications of airway management represent an important cause of morbidity and mortality. They are rare, but very severe. There is a general concern for quality in the care of the difficult airway and consequently several clinical practice guidelines (CPGs) are available for this condition. We aimed to evaluate the methodological rigour and transparency of the guidelines by using the 'Appraisal of guidelines research and evaluation' (AGREE II) instrument.
Objectives: to evaluate the quality of CPGs for the management of the difficult airway in adults and critically ill patients.
Methods: we used the AGREE II instrument, which consists of 23 items, grouped in six quality domains. Three reviewers performed data extraction and quality assessment independently. A fourth investigator conducted the analysis to obtain the overall valuation of each domain, and determined the degree of concordance using the standardized score and the intraclass correlation coefficient with an-IC of 95%. Data were analyzed using the SPSS 21.0 package.
Results: we included 12 CPGs. Of the six domains suggested by the AGREE II instrument, 'scope and purpose' was the highest score (91%) and 'applicability' the lowest score (21%); the rest of the domains ('stakeholder involvement', 'editorial independence', 'rigour of development', and 'clarity of presentation') had average scores of 52% to 81%. Interevaluator agreement was very good for most domains.
Conclusions: the AGREE II tool is an easy-to-use instrument for health professionals, which allows a choice from the methodological point of view of the most reliable CPGs in its preparation. In this case, the CPGs recommended for the treatment of difficult airways not provided for in adult and critical patients are those developed by the United Kingdom. However, by not evaluating the content, the clinical trial should accompany any decision made.
Patient or healthcare consumer involvement: none
Objectives: to evaluate the quality of CPGs for the management of the difficult airway in adults and critically ill patients.
Methods: we used the AGREE II instrument, which consists of 23 items, grouped in six quality domains. Three reviewers performed data extraction and quality assessment independently. A fourth investigator conducted the analysis to obtain the overall valuation of each domain, and determined the degree of concordance using the standardized score and the intraclass correlation coefficient with an-IC of 95%. Data were analyzed using the SPSS 21.0 package.
Results: we included 12 CPGs. Of the six domains suggested by the AGREE II instrument, 'scope and purpose' was the highest score (91%) and 'applicability' the lowest score (21%); the rest of the domains ('stakeholder involvement', 'editorial independence', 'rigour of development', and 'clarity of presentation') had average scores of 52% to 81%. Interevaluator agreement was very good for most domains.
Conclusions: the AGREE II tool is an easy-to-use instrument for health professionals, which allows a choice from the methodological point of view of the most reliable CPGs in its preparation. In this case, the CPGs recommended for the treatment of difficult airways not provided for in adult and critical patients are those developed by the United Kingdom. However, by not evaluating the content, the clinical trial should accompany any decision made.
Patient or healthcare consumer involvement: none
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