Article type
Abstract
Background: Appraising the existing guidelines is crucial in guideline adaptation process; however, such appraisal may not always uncover useful guidelines.
Objectives: The current research was conducted to identify existing clinical practice guidelines and assess their methodological quality and suitability for adaptation in the field of male lower urinary tract symptoms for the context of Iran.
Methods: A literature search was conducted on guidelines website, professional website and medical database according to the predefined clinical questions. The AGREE II Instrument (Appraisal of Guidelines Research and Evaluation II) was used to evaluate the methodological quality of selected guidelines. Clinical practice guidelines were classified into three categories of high-quality (most domains score above 60%), moderate-quality (most domains score between 30% and 60%), and low-quality (most domains score less than 30%).
Results: Nine clinical practice guidelines were recognized suitable for evaluation. After comprehensive quality assessment, all of the guidelines obtained score above 60% in domains 1 (scope and purpose), 4 (clarity of presentation), and 6 (editorial independence) of the AGREE II Instrument. In domain 5 (applicability), all of the nine guidelines acquired score less than 30%. Two guidelines and five guidelines acquired score above 60% in domains 2 (stakeholder involvement) and 3 (rigor of development) respectively. Results of the overall guideline assessment indicated that four of the guidelines were as the basic guidelines and all of their recommendations were accepted. The remaining five guidelines were considered as complementary in the development of the adapted guideline.
Conclusions and relevance: It is surprising that most of the existing guidelines regarding male lower urinary tract symptoms lack methodological quality, particularly in applicability and stakeholder involvement, although containing high-quality recommendations.
Objectives: The current research was conducted to identify existing clinical practice guidelines and assess their methodological quality and suitability for adaptation in the field of male lower urinary tract symptoms for the context of Iran.
Methods: A literature search was conducted on guidelines website, professional website and medical database according to the predefined clinical questions. The AGREE II Instrument (Appraisal of Guidelines Research and Evaluation II) was used to evaluate the methodological quality of selected guidelines. Clinical practice guidelines were classified into three categories of high-quality (most domains score above 60%), moderate-quality (most domains score between 30% and 60%), and low-quality (most domains score less than 30%).
Results: Nine clinical practice guidelines were recognized suitable for evaluation. After comprehensive quality assessment, all of the guidelines obtained score above 60% in domains 1 (scope and purpose), 4 (clarity of presentation), and 6 (editorial independence) of the AGREE II Instrument. In domain 5 (applicability), all of the nine guidelines acquired score less than 30%. Two guidelines and five guidelines acquired score above 60% in domains 2 (stakeholder involvement) and 3 (rigor of development) respectively. Results of the overall guideline assessment indicated that four of the guidelines were as the basic guidelines and all of their recommendations were accepted. The remaining five guidelines were considered as complementary in the development of the adapted guideline.
Conclusions and relevance: It is surprising that most of the existing guidelines regarding male lower urinary tract symptoms lack methodological quality, particularly in applicability and stakeholder involvement, although containing high-quality recommendations.