Appraisal of clinical practice guidelines on the management of hypothyroidism in pregnancy using the Appraisal of Guidelines for Research and Evaluation II instrument

Fang, Yuan; Yao, Liang; Sun, Jing; Zhang, Jian; Li, Yanxia; Yang, Rong; Yang, Kehu; Tian, Limin

doi:10.1007/s12020-018-1535-2

Cited by 11 publications

(8 citation statements)

References 45 publications

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“…Interestingly, this domain score was also found to be low in previous appraisals of clinical guidelines published in HNC, suggesting that the applicability of recommendations is underestimated during guidelines drafting. Finally, as also occurred in previous evaluations, domain 6 “Editorial Independence” was the most critically underperforming with an average score of 27.08% and the lowest variability (SD 4.17%), since neither an explicit statement that the funding body interests have not influenced the final recommendations nor “no conflict of interest” statement were provided in two out of three guidelines. This is a crucial issue since the prevalence of conflicts of interest has been proved to be high among members of clinical practice guideline panels …”

Section: Discussionsupporting

confidence: 60%

A critical appraisal of the quality of head and neck cancer imaging guidelines using the AGREE II tool: A EuroAIM initiative

et al. 2018

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BackgroundDiagnostic imaging guidelines are increasingly embraced in oncologic imaging in order to improve examinations appropriateness and technical quality. The usefulness of guidelines employment in clinical practice is dramatically related to the quality of the guidelines themselves. However, an extreme variability in guidelines’ quality may occur. Following a European Network for the Assessment of Imaging in Medicine (EuroAIM) initiative, the aim of this study was to assess the quality of the available guidelines regarding head and neck cancer (HNC) imaging.MethodsA literature search was conducted to identify imaging guidelines focused on HNC. Selected guidelines were evaluated by four independent appraisers using the Appraisal of Guidelines for Research & Evaluation version 2.0 (AGREE II) tool, which comprises 23 key items, rated on a 7‐point scale (1—strongly disagree to 7—strongly agree) and organized within six domains. For each domain, the intraclass correlation coefficient (ICC) was used to assess the agreement among appraisers’ scores.ResultsAfter literature search, three guidelines were selected and evaluated. One guideline scored “average” as overall quality, while the remaining two scored a “low” overall quality. The highest result (total score = 75.0% ± 19.3%) was obtained in domain 4 (Clarity of presentation) while the lowest (total score = 27.1% ± 4.2%) in domain 6 (Editorial independence). ICC analysis showed a very good agreement (range: 0.932‐0.961) among the four appraisers.ConclusionsOur results showed a heterogeneous quality of existing guidelines in HNC imaging. Issues raised from this appraisal should be considered when developing future guidelines on HNC imaging.

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Section: Discussionsupporting

confidence: 60%

A critical appraisal of the quality of head and neck cancer imaging guidelines using the AGREE II tool: A EuroAIM initiative

et al. 2018

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“…This distribution of AGREE II domain scores has been observed by many previous guideline appraisal studies, in which documents scored higher in the scope and purpose domain and the clarity of presentation domain, and lower in the applicability domain and the editorial independence domain. This domain score distribution was not only shared by guidance documents for endocrinology diseases, such as diabetes59 60 and thyroid disorders,31 61 and rheumatology diseases, such as rheumatoid arthritis32 62 63 and systemic lupus erythematosus,64 but also shared by documents for diseases in other clinical specialities 33 65–67. Despite generally low and varied scores in the applicability domain, guidance documents for gout and hyperuricemia performed obviously poorer comparing with documents for other conditions,31–33 59–61 63–67 suggesting that improving the usefulness of guidance being more challenging in gout and hyperuricemia.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment for hyperuricemia and gout: a systematic review of clinical practice guidelines and consensus statements

Wang

et al. 2019

BMJ Open

116

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ObjectivesDespite the publication of hundreds of trials on gout and hyperuricemia, management of these conditions remains suboptimal. We aimed to assess the quality and consistency of guidance documents for gout and hyperuricemia.DesignSystematic review and quality assessment using the appraisal of guidelines for research and evaluation (AGREE) II methodology.Data sourcesPubMed and EMBASE (27 October 2016), two Chinese academic databases, eight guideline databases, and Google and Google scholar (July 2017).Eligibility criteriaWe included the latest version of international and national/regional clinical practice guidelines and consensus statements for diagnosis and/or treatment of hyperuricemia and gout, published in English or Chinese.Data extraction and synthesisTwo reviewers independently screened searched items and extracted data. Four reviewers independently scored documents using AGREE II. Recommendations from all documents were tabulated and visualised in a coloured grid.ResultsTwenty-four guidance documents (16 clinical practice guidelines and 8 consensus statements) published between 2003 and 2017 were included. Included documents performed well in the domains of scope and purpose (median 85.4%, range 66.7%–100.0%) and clarity of presentation (median 79.2%, range 48.6%–98.6%), but unsatisfactory in applicability (median 10.9%, range 0.0%–66.7%) and editorial independence (median 28.1%, range 0.0%–83.3%). The 2017 British Society of Rheumatology guideline received the highest scores. Recommendations were concordant on the target serum uric acid level for long-term control, on some indications for urate-lowering therapy (ULT), and on the first-line drugs for ULT and for acute attack. Substantially inconsistent recommendations were provided for many items, especially for the timing of initiation of ULT and for treatment for asymptomatic hyperuricemia.ConclusionsMethodological quality needs improvement in guidance documents on gout and hyperuricemia. Evidence for certain clinical questions is lacking, despite numerous trials in this field. Promoting standard guidance development methods and synthesising high-quality clinical evidence are potential approaches to reduce recommendation inconsistencies.PROSPERO registration numberCRD42016046104.

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“…The most commonly used chronic medications were levothyroxine, which is used for the treatment of hypothyroidism in pregnancy [36], and methyldopa, which still is one of the main drugs for the treatment of hypertension in pregnancy [37,38]. Although it is rare, methyldopa can cause hemolytic anemia and hepatotoxicity [39,40].…”

Section: Discussionmentioning

confidence: 99%

Medication Use among Pregnant Women from the 2015 Pelotas (Brazil) Birth Cohort Study

Lutz

Miranda

Silveira

et al. 2020

IJERPH

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Background: Medication use during pregnancy is a common practice that has been increasing in recent years. The aim of this study is to describe medication use among pregnant women from the 2015 Pelotas (Brazil) Birth Cohort Study. Methods: This paper relies on a population-based cohort study including 4270 women. Participants completed a questionnaire about the antenatal period, including information about medication use. We performed descriptive analyses of the sample and the medications used and adjusted analyses for the use of medications and self-medication. Results: The prevalence of medication use was 92.5% (95% CI 91.7–93.3), excluding iron salts, folic acid, vitamins, and other minerals. The prevalence of self-medication was 27.7% (95% CI 26.3–29.1). In the adjusted analysis, women who had three or more health problems during pregnancy demonstrated higher use of medicines. Self-medication was higher in lower income groups and among smokers and multiparous women (three pregnancies or more). Acetaminophen, scopolamine, and dimenhydrinate were the medications most commonly used. Conclusions: This study describes the pattern of drug use among pregnant women in a population-based cohort study, with a high prevalence of self-medication. Greater awareness of the risks of self-medication during pregnancy is required, focusing on groups more prone to this practice, as well as ensuring qualified multidisciplinary prenatal care.

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Appraisal of clinical practice guidelines on the management of hypothyroidism in pregnancy using the Appraisal of Guidelines for Research and Evaluation II instrument

Cited by 11 publications

References 45 publications

A critical appraisal of the quality of head and neck cancer imaging guidelines using the AGREE II tool: A EuroAIM initiative

A critical appraisal of the quality of head and neck cancer imaging guidelines using the AGREE II tool: A EuroAIM initiative

Diagnosis and treatment for hyperuricemia and gout: a systematic review of clinical practice guidelines and consensus statements

Medication Use among Pregnant Women from the 2015 Pelotas (Brazil) Birth Cohort Study

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