Nutrition in critically ill adults: A systematic quality assessment of clinical practice guidelines
Por:
Padilla, PF, Martinez, G, Vernooij, RWM, Cosp, XB, Alonso-Coello, P
Publicada:
1 dic 2016
Resumen:
Background & aims: Nutritional support in the acutely ill is a complex topic. Clinical practice guidelines (CPGs) have been developed to assist healthcare professionals working in this field. However, the quality of these clinical guidelines has not yet been systematically assessed. The objective of our study was to identify and assess the quality of CPGs on nutrition in critically ill adult patients.
Methods: We performed a systematic search to identify CPGs on nutrition in critically ill adult patients. Three independent appraisers assessed six domains (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) of the eligible CPGs using the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) instrument.
Results: Nine CPGs were selected. Overall agreement among appraisers was very good (ICC: 0.853; 95% CI: 0.820-0.881). The mean scores for each AGREE domain were the following: "scope and purpose" 76.2% +/- 13.7%; "stakeholder involvement" 42.8% +/- 16.5%; "rigour of development" 57.9% +/- 18.1%; "clarity of presentation" 76.9% +/- 13.7%; "applicability" 30.1% +/- 22.8%; and 42.1% +/- 23.9% for "editorial independence". Four CPGs were deemed "Recommended"; three "Recommended with modifications"; and two "Not recommended". We did not observe improvement over time in the overall quality of the CPGs.
Conclusions: The overall quality of CPGs on nutrition in critically ill adults is suboptimal, with only four CPGs being recommended for clinical use. Our results highlight the need to revise and improve CPG development processes in this field. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Filiaciones:
Padilla, PF:
Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167,Pavello 18,Pl 0, Barcelona 08025, Spain
Univ Antofagasta, Fac Med & Dent, Antofagasta, Chile
Hosp Reg Antofagasta, Antofagasta, Chile
Martinez, G:
Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167,Pavello 18,Pl 0, Barcelona 08025, Spain
Univ Antofagasta, Fac Med & Dent, Antofagasta, Chile
Hosp Reg Antofagasta, Antofagasta, Chile
Vernooij, RWM:
Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167,Pavello 18,Pl 0, Barcelona 08025, Spain
Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
Cosp, XB:
Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167,Pavello 18,Pl 0, Barcelona 08025, Spain
Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
CIBERESP, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Alonso-Coello, P:
Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167,Pavello 18,Pl 0, Barcelona 08025, Spain
Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
CIBERESP, Barcelona, Spain
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
|