Article type
Abstract
Background: Developing trustworthy clinical practice guidelines (CPGs) requires methodological rigor to guarantee reproducibility and reliability. The mentoring program supported by the Brazilian Ministry of Health (MoH) aims to introduce standardized processes to clinical guidelines by Health Technology Assessment (HTA) centers.
Objectives:To describe the role of tutorship on the quality and the reporting of CPGs developed by HTA centers.
Methods: The planning and structure of tutorship followed the Brazilian MoH guidelines requirements based on GIN/IOM Standards. Methodologists, researchers, and MoH representatives defined the process in virtual and in-person meetings. All HTA centers tutored were inexperienced in the CPG development process. The quality of six CPGs, currently published by MoH, developed in the tutorship process, were evaluated through AGREE-2 tool and RIGHT checklist by independent researchers, not involved in the tutorship process. Descriptive data were summarized with frequencies and percentages.
Results: Between 2021-2023, the tutorship program mentored 60 researchers from 10 HTA centers to the development or update 16 clinical guidelines in the areas of psychiatry (2), neurology (4), oncology (3), hematology (2), nephrology (1), orthopedics and traumatology (1), endocrinology (1), infectious diseases (1), and gastroenterology (1). Twelve medical societies engaged in the guideline development processes. A total of 86 PICO questions (median, 7; interquartile range [IQR], 3 - 8) were made in guidelines, focusing mainly on clinical treatment questions (total, 80; median, 7; IQR, 3 - 8). Overall AGREE-2 assessment indicated higher quality of guidelines in “Rigour of development” (92.5%), “Clarity of presentation” (97.5%) and “Editorial independence” (94.4%), but diminished quality in “Applicability” (73.1%) (Figure 1A). An overall good quality of guidelines were identified (90%). Right checklist revealed higher quality of reporting in background, evidence synthesis, recommendations, review and quality assurance and “funding declaration and conflict of interest management”, however the reporting of basic information of each guideline should be better performed (Figure 1B).
Conclusion: A tutorship program may improve trustworthy guidelines to make the process of developing recommendations in the field of health policy more systematic, transparent, and comprehensible.
Objectives:To describe the role of tutorship on the quality and the reporting of CPGs developed by HTA centers.
Methods: The planning and structure of tutorship followed the Brazilian MoH guidelines requirements based on GIN/IOM Standards. Methodologists, researchers, and MoH representatives defined the process in virtual and in-person meetings. All HTA centers tutored were inexperienced in the CPG development process. The quality of six CPGs, currently published by MoH, developed in the tutorship process, were evaluated through AGREE-2 tool and RIGHT checklist by independent researchers, not involved in the tutorship process. Descriptive data were summarized with frequencies and percentages.
Results: Between 2021-2023, the tutorship program mentored 60 researchers from 10 HTA centers to the development or update 16 clinical guidelines in the areas of psychiatry (2), neurology (4), oncology (3), hematology (2), nephrology (1), orthopedics and traumatology (1), endocrinology (1), infectious diseases (1), and gastroenterology (1). Twelve medical societies engaged in the guideline development processes. A total of 86 PICO questions (median, 7; interquartile range [IQR], 3 - 8) were made in guidelines, focusing mainly on clinical treatment questions (total, 80; median, 7; IQR, 3 - 8). Overall AGREE-2 assessment indicated higher quality of guidelines in “Rigour of development” (92.5%), “Clarity of presentation” (97.5%) and “Editorial independence” (94.4%), but diminished quality in “Applicability” (73.1%) (Figure 1A). An overall good quality of guidelines were identified (90%). Right checklist revealed higher quality of reporting in background, evidence synthesis, recommendations, review and quality assurance and “funding declaration and conflict of interest management”, however the reporting of basic information of each guideline should be better performed (Figure 1B).
Conclusion: A tutorship program may improve trustworthy guidelines to make the process of developing recommendations in the field of health policy more systematic, transparent, and comprehensible.