Assessment of the quality of recommendations from 161 clinical practice guidelines using the Appraisal of Guidelines for Research and Evaluation-Recommendations Excellence (AGREE-REX) instrument shows there is room for improvement
Por:
Florez, ID, Brouwers, MC, Kerkvliet, K, Spithoff, K, Alonso-Coello, P, Burgers, J, Cluzeau, F, Fervers, B, Graham, I, Grimshaw, J, Hanna, S, Kastner, M, Kho, M, Qaseem, A, Straus, S
Publicada:
18 sep 2020
Resumen:
Objective To assess the quality of recommendations from 161 clinical practice guidelines (CPGs) using AGREE-REX-D (Appraisal of Guidelines REsearch and Evaluation-Recommendations Excellence Draft). Design Cross-sectional study Setting International CPG community. Participants Three hundred twenty-two international CPG developers, users, and researchers. Intervention Participants were assigned to appraise one of 161 CPGs selected for the study using the AGREE-REX-D tool Main outcome measures AGREE-REX-D scores of 161 CPGs (7-point scale, maximum 7). Results Recommendations from 161 CPGs were appraised by 322 participants using the AGREE-REX-D. CPGs were developed by 67 different organizations. The total overall average score of the CPG recommendations was 4.23 (standard deviation (SD) = 1.14). AGREE-REX-D items that scored the highest were (mean; SD):evidence(5.51; 1.14),clinical relevance(5.95; SD 0.8), andpatients/population relevance(4.87; SD 1.33), while the lowest scores were observed for thepolicy values(3.44; SD 1.53),local applicability(3,56; SD 1.47), andresources, tools, and capacity(3.49; SD 1.44) items. CPGs developed by government-supported organizations and developed in the UK and Canada had significantly higher recommendation quality scores with the AGREE-REX-D tool (p< 0.05) than their comparators. Conclusions We found that there is significant room for improvement of some CPGs such as the considerations of patient/population values, policy values, local applicability and resources, tools, and capacity. These findings may be considered a baseline upon which to measure future improvements in the quality of CPGs.
Filiaciones:
Florez, ID:
Univ Antioquia, Dept Pediat, Calle 67 53-108, Medellin 050001, Colombia
McMaster Univ, Dept Oncol, Juravinski Site,G2 Wing,1280 Main St West, Hamilton, ON L8S 4L8, Canada
Brouwers, MC:
Univ Ottawa, Sch Epidemiol & Publ Hlth, 101F,600 Peter Morand, Ottawa, ON K1G 5Z3, Canada
Kerkvliet, K:
McMaster Univ, Dept Oncol, Juravinski Site,G2 Wing,1280 Main St West, Hamilton, ON L8S 4L8, Canada
Spithoff, K:
McMaster Univ, Dept Oncol, Juravinski Site,G2 Wing,1280 Main St West, Hamilton, ON L8S 4L8, Canada
Alonso-Coello, P:
Hosp Santa Creu & Sant Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Burgers, J:
Dutch Coll Gen Practitioners, POB 3231, Utrecht, Netherlands
Cluzeau, F:
Imperial Coll London, St Marys Hosp, Room 1070,Queen Elizabeth Mother Wing,Praed St, London W2 1NY, England
Fervers, B:
Ctr Leon Berard, Dept Canc & Environm, 28 Rue Laennec, F-69373 Lyon 08, France
Graham, I:
Univ Ottawa, Ottawa Hosp, Res Inst, 501 Smyth Rd,Box 711, Ottawa, ON K1H 8L6, Canada
Grimshaw, J:
Univ Ottawa, Ottawa Hosp, Res Inst, 501 Smyth Rd,Box 711, Ottawa, ON K1H 8L6, Canada
Hanna, S:
McMaster Univ, Hlth Sci Ctr 2C, Fac Hlth Sci, 1280 Main St West, Hamilton, ON L8S 4L8, Canada
Kastner, M:
North York Gen Hosp, 4001 Leslie St, Toronto, ON M2K 1E1, Canada
Kho, M:
McMaster Univ, Inst Appl Hlth Sci, 1280 Main St West, Hamilton, ON L8S 4L8, Canada
Qaseem, A:
Amer Coll Physicians, 190 N Independence Mall West, Philadelphia, PA 19106 USA
Straus, S:
St Michaels Hosp, Li Ka Shing Knowledge Inst, 30 Bond St,Shuter 2-026, Toronto, ON M5B 1W8, Canada
Gold, Green Published
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