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Graham ND, Graham ID, Vanderspank-Wright B, Varin MD, Nadalin Penno L, Fergusson DA, Squires JE. A systematic review and critical appraisal of guidelines and their recommendations for sedation interruptions in adult mechanically ventilated patients. Aust Crit Care 2023; 36:889-901. [PMID: 36522246 DOI: 10.1016/j.aucc.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The objectives of the review were to (i) assess the methodological quality of all accessible and published guidelines and care bundles that offer a recommendation related to sedation interruptions, using the AGREE-II instrument, to (ii) determine what is the recommended best practice for sedation interruptions from the available guidelines, and then to have (iii) a closer inspection of the overall credibility and applicability of the recommendations using the AGREE-REX instrument. This review will benefit the outcomes of critically ill patients and the multidisciplinary team responsible for the care of mechanically ventilated adults with continuous medication infusions by providing a synthesis of the recommended action(s), actor(s), contextual information, target(s), and timing related to sedation interruptions from current best practice. REVIEW METHOD USED We conducted a systematic review. DATA SOURCES We applied a peer-reviewed search strategy to four electronic databases from 2010 to November 2021-MEDLINE, CINAHL, Embase, and The Cochrane Database of Systematic Reviews-and included grey literature. REVIEW METHOD Findings are reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses checklist. We assessed overall quality using the validated Appraisal of Guidelines for Research and Evaluation II and AGREE Recommendation Excellence tools. RESULTS We identified 11 clinical practice guidelines and care bundles comprising 15 recommendations related to sedation interruption. There are three key findings: (i) deficiencies exist with the methodological quality of included guidelines, (ii) sedation interruption is recommended practice for the care of adult mechanically ventilated patients, and (iii) the current evidence is of low quality, which impacts overall credibility and applicability of the recommendations. CONCLUSIONS Sedation interruptions are currently best practice for adult mechanically ventilated patients; however, the available guidelines and recommendations have several deficiencies. Future research is needed to further understand the role of the nurse and other actors to enact this practice.
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Affiliation(s)
- Nicole D Graham
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, P.O. Box 711, Ottawa ON, K1H 8L6, Canada; Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada; University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Brandi Vanderspank-Wright
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Melissa Demery Varin
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Letitia Nadalin Penno
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, P.O. Box 711, Ottawa ON, K1H 8L6, Canada; Department of Medicine, University of Ottawa, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, P.O. Box 711, Ottawa ON, K1H 8L6, Canada.
| | - Janet E Squires
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, P.O. Box 711, Ottawa ON, K1H 8L6, Canada.
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Karagianni MD, Tasiou A, Brotis AG, Tzerefos C, Lambrianou X, Alkiviadis T, Kalogeras A, Spiliotopoulos T, Arvaniti C, Papageorgakopoulou M, Gatos C, Fountas KN. Critical Assessment of the Guidelines-Based Management of Severe Traumatic Brain Injury with the Appraisal of Guidelines for Research and Evaluation II. World Neurosurg 2023; 176:179-188. [PMID: 36682533 DOI: 10.1016/j.wneu.2023.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Severe traumatic brain injury constitutes a clinical entity with complex underlying pathophysiology. Management of patients with severe traumatic brain injury is guided by Clinical Practice Guidelines and Consensus Statements (CPG and CS). The published CPG and CS vary in quality, comprehensiveness, and clinical applicability. The value of critically assessing CPG and CS cannot be overemphasized. The aim of our study was to assess the quality of the published CPG and CS, based on the Appraisal of Guidelines for Research and Evaluation II instrument. METHODS A systematic search was performed in PubMed, Scopus, Embase, and Web of Science focusing on guidelines and consensi about severe traumatic brain injury . The search terms used were "traumatic brain injury," "TBI," "brain injury," "cerebral trauma," "head trauma," "closed head injury," "head injury," "guidelines," "recommendations," "consensus" in any possible combination. The search period extended from 1964 to 2021 and was limited to literature published in English. The eligible studies were scored by 4 raters, using the Appraisal of Guidelines for Research and Evaluation II instrument. The inter-rater agreement was assessed using the Cronbach's alpha. RESULTS Twelve CPG and CS were assessed. Overall, the study by Carney et al. was the most Appraisal of Guidelines for Research and Evaluation II compliant study. In general, the domains of clarity of presentation, and scope and purpose, achieved the highest scores. The lowest inter-rater agreement in our analysis was "fair." CONCLUSIONS The purpose of our study for assessing the quality of CPG and CS was served. We present the strong and weak points of CPG and CS. Our findings support the idea of periodically updating guidelines and improving their rigor of development.
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Affiliation(s)
- Maria D Karagianni
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece.
| | - Anastasia Tasiou
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | - Alexandros G Brotis
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | - Christos Tzerefos
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | - Xanthoula Lambrianou
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | - Tzannis Alkiviadis
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | - Adamantios Kalogeras
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | | | - Christina Arvaniti
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | | | - Charalambos Gatos
- Department of Neurosurgery, General University Hospital of Larissa, Mezourlo, Larissa, Greece
| | - Konstantinos N Fountas
- Department of Neurosurgery, General University Hospital of Larissa, Biopolis, Larissa, Greece; Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
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3
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Bakaloudi DR, Papaemmanouil A, Vadarlis A, Makrakis D, Germanidis G, Timotheadou E, Chourdakis M. Critical evaluation and comparison of nutritional clinical practice guidelines for cancer patients. Clin Nutr 2023; 42:670-686. [PMID: 36944289 DOI: 10.1016/j.clnu.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/09/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND The growing incidence of cancer globally, and the importance of nutrition support for these patients, emphasize the need for the development of nutritional clinical practice guidelines and consensus papers (CPGs) in the field. Numerous relevant CPGs have been published by several organizations worldwide. The aim of this systematic review was to compare the content of the existing CPGs and evaluate the quality of their development using the AGREE-II tool. METHODS A systematic literature search in PubMed, Embase and Web of Science databases was conducted for the identification of relevant CPGs and consensus papers. Eligible CPGs was blindly evaluated by four appraisers according to the Appraisal of Guidelines for Research and Evaluation ΙΙ (AGREE-II) tool. RESULTS In total 15 CPGs were identified and were evaluated. All but one set of CPGs underlined the importance of nutritional screening and assessment, whereas recommendations on nutritional interventions, supplements, management of complications and nutritional follow-up were also reported by several organizations. AGREE-II results showed that two CPGs were characterized as high, eight as moderate and five as low regarding their quality of development. CONCLUSIONS Variety on recommendations could be observed between CPGs that should be considered when applied into clinical practice. Limitations of the existing CPGs could be the fact that they are non-specific and only a minority of them are focused to specific cancer types. Frequent updates for CPGs and inclusion of more nutritional topics should be considered for some CPGs. Improvement of the quality of the CPGs development should also be pursued in future.
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Affiliation(s)
- Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Department of Medical Oncology, General Hospital of Thessaloniki "G. Papageorgiou", Aristotle University of Thessaloniki, Greece; Division of Medical Oncology, Department οf Medicine, University of Washington, Seattle, WA, USA
| | - Androniki Papaemmanouil
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Andreas Vadarlis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Department of Gastroenterology and Hepatology, General Hospital of Thessaloniki ''G. Papanikolaou", Greece
| | - Dimitrios Makrakis
- Department of Medicine, Jacobi Medical Center-Albert Einstein College of Medicine, Bronx, NY, USA
| | - Georgios Germanidis
- Division of Gastroenterology and Hepatology, 1st Department of Internal Medicine, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Eleni Timotheadou
- Department of Medical Oncology, General Hospital of Thessaloniki "G. Papageorgiou", Aristotle University of Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
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Capannolo G, D'Amico A, Alameddine S, Di Girolamo R, Khalil A, Calì G, Trish IT, Coutinho CM, Herrera M, Liberati M, Lucidi A, Palacios-Jaraquemada J, Buca D, D'Antonio F. Placenta accreta spectrum disorders clinical practice guidelines: A systematic review. J Obstet Gynaecol Res 2023; 49:1313-1321. [PMID: 36796351 DOI: 10.1111/jog.15544] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/28/2022] [Indexed: 02/18/2023]
Abstract
OBJECTIVES To objectively assess the quality of the published clinical practice guidelines (CPGs) on the management of pregnancies complicated by placenta accreta spectrum (PAS)disorders. METHODS MEDLINE, Embase, Scopus, and ISI Web of Science databases were searched. The following aspects related to the management of pregnancies with suspected PAS disorders were evaluated: risk factors for PAS, prenatal diagnosis, role of interventional radiology and ureteral stenting, and optimal surgical management. The assessment of risk of bias and quality assessment of the CPGs were performed using the (AGREE II) tool (Brouwers et al., 2010). To define a CPG as of good quality we adopted a cut-off score >60%. RESULTS Nine CPGs were included. Specific risk factors for referral were assessed by 44.4% (4/9) of CPGs, mainly consisting in the presence of placenta previa and a prior cesarean delivery or uterine surgery. About 55.6% of CPGs (5/9) suggested ultrasound assessment of women with risk factors for PAS in the second and third trimester of pregnancy and 33.3% (3/9) recommended magnetic resonance imaging (MRI); 88.9% (8/9) of CPGs recommended cesarean delivery at 34-37 weeks of gestation. There was not generally consensus on the use of interventional radiology and ureteral stenting before surgery for PAS. Finally, hysterectomy was the recommend surgical approach by 77.8% (7/9) of the included CPGs. CONCLUSION Most of the published CPGs on PAS are generally of good quality. There was general agreement among the different CPGs on PAS as a regard as risk stratification, timing at diagnosis and delivery but not on the indication for MRI, use of interventional radiology and ureteral stenting.
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Affiliation(s)
- Giulia Capannolo
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Alice D'Amico
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Sara Alameddine
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Raffaella Di Girolamo
- Department of Public Health, School of Medicine, Federico II, University of Naples, Naples, Italy
| | - Asma Khalil
- Fetal Medicine Unit, Saint George's Hospital, London, UK
| | - Giuseppe Calì
- Department of Obstetrics and Gynecology, Arnas Civico Hospital, Palermo, Italy
| | - Ilan T Trish
- Department of Obstetrics and Gynecology, NYU School of Medicine, NYU Langone Health, New York, New York, USA
| | - Conrado M Coutinho
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo: Ribeirão Preto, São Paulo, Brazil
| | - Mauricio Herrera
- Maternal fetal medicine, Obstetric Department, Clinica Colsanitas Bogotà, Bogota, Colombia
| | - Marco Liberati
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Alessandro Lucidi
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | | | - Danilo Buca
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Francesco D'Antonio
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
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Yousef S, Hayawi L, Manuel D, Colman I, Papadimitropoulos M, Hossain A, Faris MA, Wells GA. Assessment of the quality and content of clinical practice guidelines (CPGs) for vitamin D and for immigrants using the AGREE-II instrument: a protocol for systematic review. Syst Rev 2022; 11:245. [PMID: 36397107 PMCID: PMC9673290 DOI: 10.1186/s13643-022-02129-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/08/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Worldwide, more immigrants experience vitamin D (vitD) deficiency than non-immigrants, which is attributed to ethnic variations, place or region of birth, skin pigmentation, clothing style, and resettlement-related changes in diet, physical activity, and sun exposure. Current recommendations in clinical practice guidelines (CPGs) concerning vitD are inadequate to address vitD deficiency among immigrants. CPGs may also lack guidance for physicians on vitD supplementation for immigrants. Moreover, there are concerns about the overall quality of these CPGs. OBJECTIVES This systematic review will collate and critically appraise CPGs relevant to immigrants' health and vitD. Moreover, we will evaluate whether the CPGs of vitD including recommendations for immigrants and clarify whether the CPGs of immigrants include recommendations on vitD. METHODS A systematic search of Ovid MEDLINE® ALL, EMBASE, and Turning Research Into Practice (TRIP) electronic databases, guideline repositories, and gray literature will be conducted to identify relevant CPGs. Two reviewers will independently evaluate the methodological quality of the retrieved guidelines using the Appraisal of Guidelines, Research, and Evaluation-II (AGREE-II) instrument. CPGs scoring ≥60% in at least four domains, including "rigor of development," will be considered high quality. CONCLUSION Evaluating the quality and content of relevant CPGs may support researchers in developing national and global guidelines for immigrants. Furthermore, it may support vitD testing, nutritional counseling, and supplementation for vulnerable immigrant sub-populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021240562.
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Affiliation(s)
- Said Yousef
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada. .,Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Room H1281, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada.
| | - Lamia Hayawi
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Douglas Manuel
- Ottawa Hospital Research Institute, Ottawa, Canada.,Institute for Clinical Evaluative Sciences, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Manny Papadimitropoulos
- Eli Lilly Canada Inc., Toronto, Canada.,Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Alomgir Hossain
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Institute for Clinical Evaluative Sciences, Ottawa, Canada
| | - Moez AlIslam Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
| | - George A Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Room H1281, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada
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Kantorová L, Klugar M. The tools at our hand to ensure the highest quality, systematicity, transparency and trustworthiness of clinical practice guidelines. United European Gastroenterol J 2022; 10:359-360. [PMID: 35524418 PMCID: PMC9103367 DOI: 10.1002/ueg2.12241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Lucia Kantorová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Czech Health Research Council, Prague, Czech Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Czech Health Research Council, Prague, Czech Republic
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
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Ghazal S, Ridha Z, D'Aguanno K, Nassim D, Quaiattini A, Netchiporouk E, Poulin Y, Kalia S, Marcoux D, Piguet V, Jack C. Treatment Guidelines for Atopic Dermatitis Since the Approval of Dupilumab: A Systematic Review and Quality Appraisal Using AGREE-II. Front Med (Lausanne) 2022; 9:821871. [PMID: 35355606 PMCID: PMC8959491 DOI: 10.3389/fmed.2022.821871] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/21/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Since its approval for adults with moderate-to-severe atopic dermatitis (AD) in 2017, dupilumab has been incorporated into clinical practice guidelines (CPGs). However, recommendations differ internationally, and the quality assessment of their development is unclear. Objective We aimed to systematically review and appraise the quality of CPGs for adult AD reported since 2017 and map the recommendations for dupilumab initiation relative to conventional systemic therapy (CST). Materials and Methods A literature search was conducted in June 2020 in MEDLINE, EMBASE, SCOPUS, and CINAHL. Twelve CPGs were retrieved. Methodological quality was assessed using the validated Appraisal of Guidelines for Research & Evaluation II tool (AGREE-II). Recommendations were extracted and compared. Results AGREE-II median scores per domain of the CPGs were (%, r = range): scope/purpose, 78% (50-96); stakeholder involvement, 54% (28-85); rigor of development, 39% (21-63); clarity of presentation, 85% (69-100); applicability, 27% (6-51); and editorial independence, 76% (42-100). Neither met the threshold of 70% quality criteria for rigor of development nor the applicability domains. Three CPGs met the criteria for recommendation without modification. CPGs' approach to dupilumab initiation was as follows: second line, preferred over CST and nbUVB (n = 1/12 CPG); second line, equivalent to CST or nbUVB (n = 3/12 CPGs); third line, after nbUVB or CST (n = 5/12 CPGs); and fourth line after nbUVB and CST (n = 2/12). No consensus was reached for n = 1/12 CPG. Conclusion and Relevance Dupilumab is now incorporated into CPGs for adult AD. These CPGs exhibited good quality in scope/purpose, clarity, and editorial independence domains. However, none met AGREE-II criteria for methodological rigor/applicability. Gaps were found in mechanisms for updates, facilitators/barriers, resource implications, and stakeholder involvement. Only n = 3/12 CPGs met quality criteria for recommendation without modifications. Of these, two favored a conservative sequential approach for the initiation of dupilumab relative to CST, while one did not reach consensus. Our findings highlight divergent recommendations AD treatment, underlining a need to incorporate quality criteria into future guideline development.
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Affiliation(s)
| | - Zainab Ridha
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | | | - David Nassim
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Andrea Quaiattini
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Elena Netchiporouk
- Division of Dermatology, McGill University Health Center, Montreal, QC, Canada.,Infectious Diseases and Immunity in Global Health, The Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Yves Poulin
- Centre de Recherche Dermatologique du Québec Métropolitain, Quebec City, QC, Canada
| | - Sunil Kalia
- Department of Dermatology and Skin Science, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Danielle Marcoux
- Department of Pediatrics, Division of Dermatology, Sainte-Justine University Hospital Center, University of Montreal, Montreal, QC, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
| | - Carolyn Jack
- Faculty of Medicine, McGill University, Montreal, QC, Canada.,Division of Dermatology, McGill University Health Center, Montreal, QC, Canada.,Infectious Diseases and Immunity in Global Health, The Research Institute of the McGill University Health Center, Montreal, QC, Canada.,Divisions of Dermatology, St. Mary's Hospital, Montreal West Island Integrated University Health and Social Services Centre, Montreal, QC, Canada.,Jewish General Hospital, Montreal West-Central Integrated University Health and Social Services Centre, Montreal, QC, Canada
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8
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Tasiou A, Brotis AG, Tzerefos C, Lambrianou X, Fountas KN. Methodological assessment of guidelines for the diagnosis and management of cerebral vasospasm using the AGREE-II tool. Neurosurg Focus 2022; 52:E11. [PMID: 35231886 DOI: 10.3171/2021.12.focus21649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/21/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Rupture of an intracranial aneurysm is the most common cause of spontaneous subarachnoid hemorrhage. Despite the recent advances in its early detection, diagnosis, and proper treatment, the outcome of patients experiencing aneurysmal subarachnoid hemorrhage (aSAH) remains poor. It is well known that cerebral vasospasm is the most troublesome complication of aSAH, while delayed cerebral ischemia related to cerebral vasospasm constitutes the major cause of unfavorable outcomes in patients with aSAH. The need for evidence-based guidelines is of great importance for the prevention, early detection, and efficient management of aSAH-induced vasospasm. Moreover, guidelines provide young physicians with a valuable tool for practicing defensible medicine. However, the methodology, clinical applicability, reporting clarity, and biases of guidelines must be periodically assessed. In this study, the authors sought to assess the reporting clarity and methodological quality of published guidelines and recommendations. METHODS A search was performed in the PubMed, Scopus, and Web of Science databases. The search terms used were "clinical practice guidelines," "recommendations," "stroke," "subarachnoid hemorrhage," and "vasospasm" in all possible combinations. The search period extended from 1964 to September 2021 and was limited to literature published in the English language. All published guidelines and recommendations reporting on the diagnosis and management of vasospasm were included. Studies other than those reporting guidelines and recommendations were excluded. The eligible studies were evaluated by three blinded raters, employing the Appraisal of Guidelines for Research & Evaluation II (AGREE-II) analysis tool. RESULTS A total of 10 sets of guidelines were evaluated in this study. The American Heart Association/American Stroke Association issued guidelines found to have the highest methodological quality and reporting clarity, followed by the European Stroke Organization guidelines and the English edition of the Japanese guidelines issued by the Japanese Society on Surgery for Cerebral Stroke. The interrater agreement was moderate in the current analysis. CONCLUSIONS These findings support the idea that improvement of currently existing guidelines is feasible in the following domains: the rigor of guidelines and recommendations development, clinical applicability, editorial independence, and stakeholder involvement. Furthermore, periodic updating of published guidelines requires improvement in the future.
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Brotis AG, Karvouniaris M, Tzerefos C, Gatos C, Fountas KN. Guidelines on the use of external ventricular drain and its associated complications: do we "AGREE II"? Br J Neurosurg 2021; 35:689-695. [PMID: 34365868 DOI: 10.1080/02688697.2021.1958153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Insertion of an external ventricular drain is a common procedure used in everyday practice by neurosurgeons all around the world. It consists of the placement of an external ventricular drain (EVD) into the ventricular system providing the ability to measure intracranial pressure, and also divert the flow of cerebrospinal fluid (CSF) in a variety of pathological conditions. The most common complication is infection, and it may result in devastating consequences and negatively affect the outcome of these patients. The Infectious Diseases Society of America (IDSA), the Neurocritical Care Society (NCS), and The Society for Neuroscience in Anesthesiology & Critical Care (SNACC) have published recommendations for the management of EVD-Associated Ventriculitis. The objective of this study was to assess the methodological quality and reporting clarity of these recommendations using the AGREE-II tool. We found that the overall quality of the published clinical practice guidelines is acceptable. However, continuous updates and external validation should be implemented.
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Affiliation(s)
- Alexandros G Brotis
- Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece
| | - Marios Karvouniaris
- Department of Intensive Care Unit, General University Hospital of Larissa, Larissa, Greece
| | - Christos Tzerefos
- Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece
| | - Charalambos Gatos
- Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece
| | - Konstantinos N Fountas
- Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece.,Faculty of Medicine, University of Thessaly, Larissa, Greece
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Ciapponi A, Tapia-López E, Virgilio S, Bardach A. The quality of clinical practice guidelines for preoperative care using the AGREE II instrument: a systematic review. Syst Rev 2020; 9:159. [PMID: 32660571 PMCID: PMC7359265 DOI: 10.1186/s13643-020-01404-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/01/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs). METHODS Systematic review of clinical practice guidelines. DATA SOURCES PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase, and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists, and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence, and strength of recommendations according to the GRADE methodology. RESULTS We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last 5 years and seven used GRADE. The median (percentile 25-75) AGREE-II scores for rigor of development was 49% (35-76%) and the domain "applicability" obtained the worst score 16% (9-31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. "Guidelines' applicability" and "monitoring" were the most deficient domains. Only half of the EB-CPGs were updated in the past 5 years. CONCLUSIONS We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines' quality.
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Affiliation(s)
- Agustín Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
| | - Elena Tapia-López
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina
| | - Sacha Virgilio
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina
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Zafra-Tanaka JH, Goicochea-Lugo S, Villarreal-Zegarra D, Taype-Rondan A. Characteristics and quality of clinical practice guidelines for depression in adults: a scoping review. BMC Psychiatry 2019; 19:76. [PMID: 30786870 PMCID: PMC6381686 DOI: 10.1186/s12888-019-2057-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 02/12/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Clinical Practice Guidelines (CPGs) should follow an adequate methodology using an evidence-based approach in order to provide reliable recommendations. However, little is known regarding the quality of CPGs for Depression, which precludes its adequate use by stakeholders and mental health professionals. Thus, the aim of this study was to conduct a scoping review to describe the characteristics and quality of CPGs for Depression in adults. METHODS We searched CPGs for Depression in adults in eighteen databases. We included those that were published in English or Spanish between January 2014 and May 2018 and were based on systematic reviews of the evidence. Two independent authors extracted the characteristics, type and number of recommendations, and quality (using the Appraisal of Guidelines for Research and Evaluation-II [AGREE-II]) of each included CPG. RESULTS We included eleven CPGs, of which 9/11 did not include the participation of patients in the development of the CPG, 4/11 CPGs had a score ≥ 70% in the overall evaluation of AGREE-II, and 3/11 CPGs had a score ≥ 70% in its third domain (rigor of development). In addition, only 5/11 CPGs shared their search strategy, while only 4/11 listed the selected studies they used to reach recommendations, and 7/11 CPGs did not clearly state which methodology they used to translate evidence into a recommendation. CONCLUSIONS Most of evaluated CPGs did not take into account the patient's viewpoints, achieved a low score in the rigor of development domain, and did not clearly state the process used to reach the recommendations. Stakeholders, CPCGs developers, and CPGs users should take this into account when choosing CPGs, and interpreting and putting into practice their issued recommendations.
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Affiliation(s)
| | | | - David Villarreal-Zegarra
- Universidad Peruana Cayetano Heredia, CRONICAS Centre of Excellence for Chronic Diseases, Lima, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - Alvaro Taype-Rondan
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Av. La Fontana 550, La Molina, Lima, Peru
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Abstract
Objective The objective of this study was to systematically appraise the quality of an evidenced-based clinical algorithm for the clinical assessment of hypotonia in children. Design The Appraisal of Guidelines for Research and Evaluation (AGREE) II tool with 23 items and six domains was used. The study was located in South Africa. Ten appraisers, who were recruited based on specific selection criteria, completed the assessment. Results Nine appraisers recommended the EBCA without any modification. Scope and purpose (94%), stakeholder involvement (91%) and editorial independence (99%) were rated the highest with the lower scoring domains being clarity of presentation (85%) and applicability (86%) due to clarity required in areas of resource implications and auditing and monitoring criteria. Inter-rater reliability was strong (ICC 0.7) amongst the appraisers in this study. Conclusion This is the first independent assessment of the methodological rigour and transparency of a clinical algorithm using the AGREE-II instrument. Determining the quality of the EBCA for practice is essential as this would ultimately aid clinicians towards more accurate clinical assessment of hypotonia which would inevitably impact outcomes and management of the child presenting with this symptom. Whilst the AGREE-II provided initial feedback on the methodological rigour of development, understanding that the AGREE-II instrument evaluates the guideline development process and not the content is also essential in order to consider the next stage which would be to consider clinicians feedback on the clinical utility of this EBCA.
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Larenas Linnemann DES, Del Río Navarro BE, Luna Pech JA, Romero Lombard J, Villaverde Rosas J, Cano Salas MC, Fernández Vega M, Ortega Martell JA, López Estrada EC, Mayorga Butrón JL, Salas Hernández J, Vázquez García JC, Ortiz Aldana I, Vargas Becerra MH, Bedolla Barajas M, Rodríguez Pérez N, Aguilar Aranda A, Jiménez González CA, García Bolaños C, Garrido Galindo C, Mendoza Hernández DA, Mendoza López E, López Pérez G, Wakida Kuzonoki GH, Ruiz Gutiérrez HH, León Molina H, Martínez de la Lanza H, Stone Aguilar H, Gómez Vera J, Olvera Salinas J, Oyoqui Flores JJ, Gálvez Romero JL, Lozano Saenz JS, Salgado Gama JI, Jiménez Chobillon MA, García Avilés MA, Guinto Balanzar MP, Medina Ávalos MA, Camargo Angeles R, García Torrentera R, Toral Freyre S, Montes Narvaez G, Solorio Gómez H, Rosas Peña J, Romero Tapia SJ, Reyes Herrera A, Cuevas Schacht F, Esquer Flores J, Sacre Hazouri JA, Compean Martínez L, Medina Sánchez PJ, Garza Salinas S, Baez Loyola C, Romero Alvarado I, Miguel Reyes JL, Huerta Espinosa LE, Correa Flores MÁ, Castro Martínez R. Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico. Allergol Immunopathol (Madr) 2018; 46:291-303. [PMID: 29288048 DOI: 10.1016/j.aller.2017.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 05/19/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.
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Affiliation(s)
| | - B E Del Río Navarro
- Department of Allergy and Clinical Immunology, Pediatric Hospital of Mexico "Federico Gómez", Mexico City, Mexico; Postgraduate Department, Medical Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - J A Luna Pech
- Department of Philosophical, Methodological and Instrumental Disciplines, University Center of Science in Health, Universidad de Guadalajara, Mexico
| | | | - J Villaverde Rosas
- A2DAHT Iberoamerican Agency for Development & Assessment of Health Technologies, Mexico City, Mexico
| | - M C Cano Salas
- Department of Postgraduate Medicine of the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - M Fernández Vega
- Dean's Office, of the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico; Pregraduate Pulmonology Department, Medical Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - J A Ortega Martell
- Department of Pre and Postgraduate Medicine, Universidad Autónoma de Hidalgo, Pachuca, Mexico
| | - E C López Estrada
- Asthma Clinic, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | - J L Mayorga Butrón
- Postgraduate Department, Medical Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico; A2DAHT Iberoamerican Agency for Development & Assessment of Health Technologies, Mexico City, Mexico; ENT Department, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - J Salas Hernández
- General Management Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico.
| | - J C Vázquez García
- Dean's Office, of the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - I Ortiz Aldana
- Secretary of Health of the State of Guanajuato, Guanajuato (Gto), Mexico
| | - M H Vargas Becerra
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico; Unit of Medical Investigations in Respiratory Medicine, of the Instituto Mexicano del Seguro Social, Mexico
| | - M Bedolla Barajas
- Civil Hospital of Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Mexico
| | - N Rodríguez Pérez
- Institute of Science and Superior Studies of Tamaulipas, Universidad Autónoma de Tamaulipas, Matamoros, Mexico
| | - A Aguilar Aranda
- Medical Unit of High-Level Specialization, of Hospital de Pediatría Centro Médico de Occidente, Mexico
| | | | - C García Bolaños
- General Hospital "Doctor Gaudencio González Garza" of the Centro Médico Nacional La Raza, Mexico City, Mexico
| | - C Garrido Galindo
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | | | - E Mendoza López
- Sistema Tec Salud, Hospital San José, Monterrey (NL), Mexico
| | - G López Pérez
- Allergy Department, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | - H H Ruiz Gutiérrez
- Servicio de Neumología Pediátrica, Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco, Mexico
| | | | | | | | - J Gómez Vera
- Allergy Department, Hospital Regional Lic. Adolfo López Mateos, ISSSTE, Mexico City, Mexico
| | | | | | - J L Gálvez Romero
- Instituto de Seguridad y de Servicios Sociales de los Trabajadores del Estado (ISSSTE), Regional, Puebla, Puebla, Mexico
| | | | - J I Salgado Gama
- Clínica del Niño y del Adolescente de Coatzacoalcos (Veracruz), Mexico
| | | | - M A García Avilés
- Secretary of Health, National Center for Preventive Programs for Disease Control (CENAPRECE), Mexico City, Mexico
| | | | - M A Medina Ávalos
- Instituto de Seguridad y de Servicios Sociales de los Trabajadores del Estado (ISSSTE) of Veracruz, Mexico
| | - R Camargo Angeles
- Secretary of Health, National Center for Preventive Programs for Disease Control (CENAPRECE), Mexico City, Mexico
| | - R García Torrentera
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | - S Toral Freyre
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | | | | | - J Rosas Peña
- Private Practice, Guadalajara, Guadalajara, Mexico
| | - S J Romero Tapia
- Unit of Education and Investigation, Hospital de Alta Especialidad del Niño "Dr. Rodolfo Nieto Padrón", Villahermosa, Tabasco, Mexico; Profesor Investigador de la División Académica de la Universidad Juárez Autónoma de Tabasco, Mexico
| | | | - F Cuevas Schacht
- Department of Pulmonology and Thoracic Surgery, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - J Esquer Flores
- Hospital del ISSSSTE, 'Fray Junipero Serra', Tijuana, BC, Mexico
| | | | - L Compean Martínez
- Servicio de Otorrinolaringología del Centenario Hospital Hidalgo de Aguascalientes, Mexico
| | | | | | | | - I Romero Alvarado
- Emergency Department, Hospital Infantil de México "Federico Gómez", Mexico City, Mexico
| | - J L Miguel Reyes
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | - L E Huerta Espinosa
- Pediatric Hospital of Legaria of the Secretary of Health, Mexico City, Mexico
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de María Díaz Granados L, Quijano MA, Ramírez PA, Aguirre N, Sanclemente G. Quality assessment of atopic dermatitis clinical practice guidelines in ≤ 18 years. Arch Dermatol Res 2017; 310:29-37. [PMID: 29127480 DOI: 10.1007/s00403-017-1791-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/13/2017] [Accepted: 11/01/2017] [Indexed: 12/13/2022]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects the patients' quality of life greatly often from a very young age. Its worldwide incidence in children and adults varies, but it is usually among the first ten causes of dermatological consultation worldwide. There is a wide variety of treatment options for this condition including topical and systemic regimes. The decision to choose a treatment option in dermatological diseases is greatly influenced by the personal experience of each specialist, which increases variability in the selection of available therapies. Clinical practice guidelines (CPGs) not only offer recommendations supported on the available scientific evidence, but also are intended to assist in making appropriate decisions in clinical scenarios. To standardize the way in which CPGs should be developed, an instrument called AGREE II (Appraisal of Guidelines for Research and Evaluation) is used. In this study, ten clinical practice guidelines in ≤ 18 years were evaluated. Six domains (scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence) were assessed for each guideline, by three reviewers. Most of the domains obtained high scores except in the applicability domain. It is suggested that future atopic dermatitis CPGs should emphasize in the facilitating factors and barriers that may influence the application of guideline recommendations.
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Affiliation(s)
- Luz de María Díaz Granados
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - María Adelaida Quijano
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - Paola Andrea Ramírez
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - Natalia Aguirre
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - Gloria Sanclemente
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia. .,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia. .,IPS Universitaria, Universidad de Antioquia, Cra. 51c #62-42, Medellín, Colombia.
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Pearson EJM, Morris ME, McKinstry CE. Cancer-related fatigue: appraising evidence-based guidelines for screening, assessment and management. Support Care Cancer 2016; 24:3935-42. [PMID: 27116014 DOI: 10.1007/s00520-016-3228-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/17/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE There is inconsistent management of cancer-related fatigue (CRF) by health professionals worldwide. This research aims to identify the most appropriate guidelines for the management of cancer-related fatigue. METHODS A systematic search of international literature identified evidence-based clinical practice guidelines for CRF. Four reviewers independently appraised the highest quality guidelines using the AGREE-II instrument and National Heath and Medical Research Council (NHMRC) guideline standards. RESULTS Five guidelines met the inclusion criteria. Of these, the 2015 Canadian Association of Psychosocial Oncology (CAPO) CRF guidelines and the 2014 American Society of Clinical Oncology (ASCO) fatigue guidelines for cancer survivors were selected for in-depth appraisal. The CAPO guideline scored higher than the ASCO for five domains of the AGREE-II. For one domain, the differences were statistically significant (p ≤ 0.05). The CAPO guideline met 37 of 47 NHMRC mandatory guideline standards and the ASCO guideline met 20. The difference in the proportion of standards met was statistically significant for one domain (p ≤ 0.05). Both guidelines had low scores for applicability and implementation. CONCLUSIONS Currently, the CAPO guideline for cancer-related fatigue has the strongest evidence for use. To enhance implementation, further strategies for guideline dissemination and application are needed.
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Affiliation(s)
| | - Meg E Morris
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Carol E McKinstry
- Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Jakes AD, Marec-Berard P, Phillips RS, Stark DP. Critical Review of Clinical Practice Guidelines for Fertility Preservation in Teenagers and Young Adults with Cancer. J Adolesc Young Adult Oncol 2014; 3:144-152. [PMID: 25538859 PMCID: PMC4270154 DOI: 10.1089/jayao.2014.0032] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The 5-year survival of teenagers and young adults (TYAs; 13-24 years old) with cancer has continued to rise, but as a result more patients experience late effects of treatment, such as infertility. Advice regarding fertility preservation in relation to cancer is provided in numerous clinical practice guidelines, but the rigor of their development is unclear. Methods: A systematic search was undertaken for clinical practice guidelines regarding fertility preservation in TYAs with cancer. All guidelines were reviewed according to the Appraisal of Guidelines for Research and Evaluation (AGREE-II) criteria. Five out of 13 identified guidelines scored over 75% in the "rigor of development" section and were further appraised. Content, scope, and consistencies between recommendations were also examined. Results: All five of the reviewed guidelines encouraged oncologists to have discussions with their patients about potential fertility issues associated with treatment and available fertility preservation methods. The cryopreservation of sperm, oocytes, and embryos were all recommended as first-line interventions in postpubertal patients. Recommendations surrounding pre- or peripubescent adolescents were few, with many techniques only recommended as part of a clinical trial. The risk of subfertility associated with different treatment regimens was poorly described. Conclusions: The methodology and development of guidelines describing fertility preservation in TYA cancer patients varied greatly. Methodological quality did not clearly influence key recommendations. Those involved with the development of guidelines are encouraged to clearly define their development methods to allow users to be confident of the quality.
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Affiliation(s)
- Adam D. Jakes
- Leeds Institute of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | - Robert S. Phillips
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Daniel P. Stark
- Leeds Institute of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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