Comparison of the methodological quality and transparency of Brazilian practice guidelines

Abstract

This study aims to compare the differences between clinical practice guidelines (CPGs) of the Ministry of Health (MoH) and those of other Brazilian health institutions. A systematic review of Brazilian CPGs was carried out. CPGs with recommendations for the pharmacological treatment of non-communicable disease (NCDs) were included. CPG methodological quality and transparency was independently assessed by 2 reviewers using the AGREE II. CPGs were rated as high, moderate, and low quality (ranging from A to C). Twenty-six CPGs were assessed for quality. MoH CPGs were published more recently, and were of better quality than the others: 6/6 (100%) were rated as Moderate-A. Although CPGs presented a wide range of methodological quality and transparency, MoH CPGs presented better consistency in the preparation method. To avoid confusion and to improve the quality of care within finite resources in Brazil, and to avoid potential bias, conflicts of interest, national CPGs used within SUS should be developed by Conitec with partners who have no conflict of interest.

Brazilian Clinical Practice Guidelines for Sexually Transmitted Infections That Cause Urethral Discharge: Assessment According to the AGREE II and Critical Analysis Based on the WHO Recommendations

“…Similar to previous reviews of the Brazilian guidelines for different diseases in comparison with international counterparts, applicability, and editorial independence domains scored the lowest 20–24 . The applicability domain relates to potential barriers to guideline implementation and monitoring criteria to assess a guideline's impact 13 .…”

“…Similar to previous reviews of the Brazilian guidelines for different diseases in comparison with international counterparts, applicability, and editorial independence domains scored the lowest. [20][21][22][23][24] The applicability domain relates to potential barriers to guideline implementation and monitoring criteria to assess a guideline's impact. 13 Pereira et al 25 summarize the evidence on the effective strategies to promote clinical practice guideline implementation and dissemination; they cited educational materials as one of the most reported interventions.…”

“…The analysis comprises 6 domains with a total of 23 items corresponding to (1) scope and purpose (items 1-3), (2) stakeholder involvement (items 4-6), (3) rigor of development (items 7-14), (4) clarity of presentation (items 15-17), ( 5) applicability (items 18-21), and (6) editorial independence (items [22][23]. For each of the AGREE II items, a rating was assigned on a scale of 1 to 7, in which 1 means strongly disagree and 7 strongly agree.…”

e usos de evidências no Brasil : conceitos, métodos, contextos e práticas

“…Isso compromete a qualidade do protocolo. Ainda que em pouco tempo o MS tenha sido capaz de organizar os processos de trabalho da Conitec e de produzir PCDTs com maior qualidade e transparência do que as guias de prática clínica elaboradas por sociedades de especialidades e pela Associação Médica Brasileira, o órgão ainda não obteve o nível mais elevado de qualidade para esses PCDTs (Molino et al, 2019).…”