Article type
Abstract
"Background: CPGs are recognized as the product of a rigorous development process that informs best practices in diagnosis, treatment, and management. When standards are not followed, reliability, applicability, and overall quality of guidelines suffers. To promote awareness of this problem, we evaluated the methodological rigor of CPGs focusing on adults hospitalized with bacterial pneumonia, a superimposed complication of the COVID-19 pandemic, globally.
Methods: The team used JBI methodology for scoping reviews. A three-step literature search and screening process was conducted to identify professionally endorsed guidelines for adults hospitalized with bacterial pneumonia, published in any language during the last five years. Of 1233 records retrieved, 66 were moved to full text screening. Fifty-one records were excluded, leaving 15 reports for data extraction. Four members independently extracted data using all 23 items of the AGREE II instrument; team discussions after extraction led to general agreements. CPG languages were English (n=10), Spanish (n=3), German (n=1), and Russian (n=1). The team used DeepL translatorTM to translate the German, Russian, and Spanish CPGs into English. Translated English versions of Spanish and German CPGs were audited and deemed accurate by two persons fluent in the original languages.
Results: Appraisals with the AGREE II instrument showed scaled domain scores were highly variable within and between guidelines. Within guidelines, two domains showed evidence of low quality with scores <50%; Domain 3 (rigor of development = 45%) and Domain 5 (applicability = 38%). Between guidelines, overall methodological rigor showed a mean score of 60% with seven CPGs meeting the criteria for high quality (>70%), five for sufficient quality (50% - 69%), and three for low quality (<50%). Based on the AGREE II scores, the team affirmed sufficient methodological rigor in three out of the 15 included CPGs.
Conclusions: This review alerts clinicians and professional organizations who endorse guidelines to be mindful of the development standards set forth by the professional community. When methodological rigor is not upheld, clinicians may inadvertently jeopardize patient health. Therefore, it is vital to adhere to standards known to produce quality CPGs to warrant clinicians’ confidence and use.
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Methods: The team used JBI methodology for scoping reviews. A three-step literature search and screening process was conducted to identify professionally endorsed guidelines for adults hospitalized with bacterial pneumonia, published in any language during the last five years. Of 1233 records retrieved, 66 were moved to full text screening. Fifty-one records were excluded, leaving 15 reports for data extraction. Four members independently extracted data using all 23 items of the AGREE II instrument; team discussions after extraction led to general agreements. CPG languages were English (n=10), Spanish (n=3), German (n=1), and Russian (n=1). The team used DeepL translatorTM to translate the German, Russian, and Spanish CPGs into English. Translated English versions of Spanish and German CPGs were audited and deemed accurate by two persons fluent in the original languages.
Results: Appraisals with the AGREE II instrument showed scaled domain scores were highly variable within and between guidelines. Within guidelines, two domains showed evidence of low quality with scores <50%; Domain 3 (rigor of development = 45%) and Domain 5 (applicability = 38%). Between guidelines, overall methodological rigor showed a mean score of 60% with seven CPGs meeting the criteria for high quality (>70%), five for sufficient quality (50% - 69%), and three for low quality (<50%). Based on the AGREE II scores, the team affirmed sufficient methodological rigor in three out of the 15 included CPGs.
Conclusions: This review alerts clinicians and professional organizations who endorse guidelines to be mindful of the development standards set forth by the professional community. When methodological rigor is not upheld, clinicians may inadvertently jeopardize patient health. Therefore, it is vital to adhere to standards known to produce quality CPGs to warrant clinicians’ confidence and use.
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