Are paediatric clinical practice guidelines trustworthy?

Abstract

Aim To assess the methodological and reporting quality of paediatric clinical practice guidelines (CPGs) in National Guideline Clearinghouse (NGC) using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and Reporting Items for Practice Guidelines in Healthcare (RIGHT) standard. Methods We identified all published CPGs through the NGC, and search records were screened in duplicate for inclusion. Two researchers evaluated the methodological and reporting quality of paediatric CPGs using the AGREE II instrument and RIGHT standard. STATA version 12.0 and SPSS version 22.0 software were used to analyse the related data. Results A total of 50 paediatric CPGs were included. The scores for all six domains by AGREE II instrument were presented as follows: scope and purpose (85.6 ± 9.59), stakeholder involvement (69.15 ± 19.32), rigour of development (73.19 ± 17.18), clarity of presentation (78.51 ± 14.36), applicability (54.61 ± 22.63) and editorial independence (68.42 ± 13.06). In the seven domains of the RIGHT standard, the reporting rate of the recommendation domain was the lowest (52.86%).The highest reporting rate was the other information domain, which was 68%.There was a high correlation between reporting the completeness of CPGs using the AGREE II instrument and RIGHT standard (r = 0.77, P < 0.001). Conclusions The paediatric CPGs from NGC have good quality. There was a high correlation in the completeness of reporting for paediatric CPGs using the AGREE II instrument and RIGHT standard. It could be concluded that the CPGs of good methodological quality have good reporting quality. Maybe the researcher should effectively combine the AGREE II instrument and RIGHT standard in the development process of CPGs.

Methodological and reporting quality of pediatric clinical practice guidelines: a systematic review

“…The quality of the pediatric CPGs included in our study may be also lower than those indexed in professional guideline libraries such as RIGHT. Sun et al assessed the methodological quality of 50 pediatric CPGs in NGC using the AGREE-II instrument (22). According to their findings, only one domain (domain 5, Applicability, 54.6%) had a mean AGREE II score below 60%.…”

Preschool wheezing and asthma in children: A systematic review of guidelines and quality appraisal with the AGREE II instrument

“…Finally, some of the reviewers/appraisers had no previous experience with the AGREE II instrument. Therefore, all reviewers were asked to take part in the recommended AGREE II consortium online training, which was in accordance with other AGREE evaluation groups 34,40 …”

“…The AGREE II instrument was used in the appraisal of several guidelines, consistently showing differences in quality between different guidelines. [34][35][36][37][38][39][40] Strikingly, a substantial portion of the published guidelines remains at least, average quality. Moreover, there is a visible scarcity in guidelines regarding preschool wheezing.…”

“…Therefore, all reviewers were asked to take part in the recommended AGREE II consortium online training, which was in accordance with other AGREE evaluation groups. 34,40 Another possible drawback is that, even though the AGREE II tool is considered both valid and reliable, this instrument has its limitations, such as lack of clear criteria for applying each point on the Likert scale. We could see tendency in our scoring to score either low or high, which is result of rather dichotomic answer to many AGREE questions.…”