Appraisal of clinical practice guidelines on community-acquired pneumonia in children with AGREE II instrument

Abstract

BackgroundCommunity-acquired pneumonia (CAP) remains a major cause of morbidity and mortality worldwide among children. The growing number of guidelines have been accompanied with a growing concern about variance and conflicts among guideline recommendations. There is a need to critically appraise clinical practice guidelines (CPGs) in order to ensure safe and effective practices.MethodsA literature search was systematically conducted in English and Chinese major academic databases (from January 2000 to March 2015). CPGs related to CAP in children were evaluated by four independent assessors, according to AGREE II instruments. Standardized domain scores were calculated for each guideline. Inter-rater reliability was assessed by intraclass correlation coefficient. The software used for analysis was SPSS 17.0.ResultsA total of 10 guidelines met the inclusion criteria and were appraised. Scope and purpose (69.03 %) and clarity of presentation (83.33 %) achieved relative high scores, while the scores of the other four domains were low: stakeholder involvement (42.78 %), rigour of development (44.95 %), applicability (37.60 %), and editorial independence (23.74 %). 3 guidelines were strongly recommended as a result of the overall scores were greater than 60 %.ConclusionThe qualities of CPGs for CAP in children were generally acceptable with several flaws. Stakeholder involvement, rigour of development, applicability and editorial independence should be considered and well described in the future development of CPGs.

A Review of the Quality of Extant Clinical Practice Guidelines in Cancer Therapy-Induced Mucositis

“…The domain of editorial independence focuses on the investment of issues and conflict of interest for all of the involvement members (Items 22 -23) (16). In the present study, we found that assessed guideline had the lowest score in this domain.…”

“…In stakeholders' involvement domain, it was assessed whether the professional group is presented, patients' preference and perspective have been acquired, and intended users of guideline clearly has been defined (items 4 -6) (16). In the present study, stakeholders involvement domain had a higher score than other domains except for clarity of presentation and scope and purpose do- mains (median score, 54.4%) but its score was not favorable.…”

“…The rigor of development is the core of the methodology of guidelines and continued search processes of evidence, grading, briefing and formulation of recommendations (Items 7 -14) (16). The present study showed domain of rigor of development (median score, 28.8%) was in unfavorable condition.…”

“…In the present study, applicability (median score; 30%) took an unfavorable score. In two studies of Sabharwal, et al, Xie, et al and Deng, et al, this domain obtained the lowest score amongst all domains of the AGREE II instrument and in other studies; applicability domain took weak score among the 6 domains of AGREE II instrument (11,13,(15)(16)(17)(18). The weak scores in applicability domain place emphasis on the necessity of improving the conceptualization in guideline implementation during the development process.…”

An appraisal of practice guidelines for smoking cessation in people with severe mental illness

“…In keeping with guidelines for other topics, the "Scope and purpose" domain consistently received high scores (≥60%), followed by "Clarity of presentation" where all but two guidelines scored highly (Polus et al, 2012;Sabharwal et al, 2014;Xie et al, 2016). Many of the assessed guidelines presented their recommendations using flow charts, boxes, tables, and coloured fonts as required by the AGREE II scoring criteria.…”