Article type
Abstract
"Introduction: Biomarkers are invaluable tools for clinicians, enabling them to optimize patient care at the bedside. The information derived from clinical guidelines plays a pivotal role in establishing evidence-based practices. However, a description and evaluation of the recommendations for biomarkers use in adults with sepsis is still needed.
Objective: To identify, describe and display in an Evidence and Gap Map (EGM) the clinical guidelines and recommendations on the use of biomarkers for the management of adults with sepsis.
Methods: Scoping review. We searched for clinical guidelines in Medline, Guidelines International Network, Pan American Health Organization, Trip Database and UpToDate from 2016 to July 2022. Two reviewers independently applied the eligibility criteria and extracted data. We used the Appraisal of Guidelines for Research and Evaluation-II (AGREE II) tool to assess the quality of the included documents. We displayed the recommendations in an evidence gap map.
Results: We found eight guidance documents, mostly oriented for the general population (75%). Only half of these documents had a robust methodology (scored above 50% in the AGREE II Rigour of development; domain). From these guidelines, we extracted 28 recommendations, of which 17 (60.7%) were developed with GRADE. The recommendations targeted a total of five biomarkers, with 25 (89.2%) recommendations focused on a single biomarker. Lactate and procalcitonin were the most frequent ones, mainly with prognostic purposes (85.8% and 46.4% for treatment
monitoring). Most recommendations pointed to using the biomarker (85.7%) with a strength graded as strong (14/28; 50%) or conditional (12/28; 42.8%).
Conclusions: This scoping review identified and evaluated the clinical guidelines and the recommendations on the use of biomarkers for the management of adults with sepsis. Only half of the guidelines presented a robust methodology. The consistency of the recommendations were low, and only a few biomarkers, mainly lactate and procalcitonin, were addressed, mostly for prognostic issues. The role of these biomarkers for sepsis needs to be better evaluated, and improvements in the guidelines methodological approaches could help to obtain more valid and applicable recommendations."
Objective: To identify, describe and display in an Evidence and Gap Map (EGM) the clinical guidelines and recommendations on the use of biomarkers for the management of adults with sepsis.
Methods: Scoping review. We searched for clinical guidelines in Medline, Guidelines International Network, Pan American Health Organization, Trip Database and UpToDate from 2016 to July 2022. Two reviewers independently applied the eligibility criteria and extracted data. We used the Appraisal of Guidelines for Research and Evaluation-II (AGREE II) tool to assess the quality of the included documents. We displayed the recommendations in an evidence gap map.
Results: We found eight guidance documents, mostly oriented for the general population (75%). Only half of these documents had a robust methodology (scored above 50% in the AGREE II Rigour of development; domain). From these guidelines, we extracted 28 recommendations, of which 17 (60.7%) were developed with GRADE. The recommendations targeted a total of five biomarkers, with 25 (89.2%) recommendations focused on a single biomarker. Lactate and procalcitonin were the most frequent ones, mainly with prognostic purposes (85.8% and 46.4% for treatment
monitoring). Most recommendations pointed to using the biomarker (85.7%) with a strength graded as strong (14/28; 50%) or conditional (12/28; 42.8%).
Conclusions: This scoping review identified and evaluated the clinical guidelines and the recommendations on the use of biomarkers for the management of adults with sepsis. Only half of the guidelines presented a robust methodology. The consistency of the recommendations were low, and only a few biomarkers, mainly lactate and procalcitonin, were addressed, mostly for prognostic issues. The role of these biomarkers for sepsis needs to be better evaluated, and improvements in the guidelines methodological approaches could help to obtain more valid and applicable recommendations."