Guidelines for the symptomatic management of fever in children: systematic review of the literature and quality appraisal with AGREE II

Abstract

IntroductionSeveral societies have produced and disseminated clinical practice guidelines (CPGs) for the symptomatic management of fever in children. However, to date, the quality of such guidelines has not been appraised.ObjectiveTo identify and evaluate guidelines for the symptomatic management of fever in children.MethodsThe research was conducted using PubMed, guideline websites, and Google (January 2010 to July 2016). The quality of the CPGs was independently assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, and specific recommendations in guidelines were summarised and evaluated. Domain scores were considered of sufficient quality when >60% and of good quality when >80%.ResultsSeven guidelines were retrieved. The median score for the scope and purpose domain was 85.3% (range 66.6–100%). The median score for the stakeholder involvement domain was 57.5% (range 33.3–83.3%) and four guidelines scored >60%. The median score for the rigour of development domain was 52.0% (range 14.6–98.9%), and only three guidelines scored >60%. The median score for the clarity of presentation domain was 80.9% (range 50.0–94.4%). The median score for the applicability domain was 39.3% (8.3–100%). Only one guideline scored >60%. The median score for the editorial independence domain was 48.84% (0–91.6%); only three guidelines scored >60%.ConclusionMost guidelines were recommended for use even if with modification, especially in the methodology, the applicability and the editorial independence domains. Our results could help improve reporting of future guidelines, and affect the selection and use of guidelines in clinical practice.

Knowledge, Attitude, and Practice in Management of Childhood Fever Among Saudi Parents

“…2,3 Fever phobia among others has also been documented in parents, causing most frequent hospital visits from several studies including Italy, Ireland, Jordan, Nigeria, Canada, Morocco, and France. [4][5][6] The reported outcomes of such studies uncovered several aspects including inadequate parental knowledge regarding fever leading to erroneous approach to fever such as inappropriate usage of antipyretic drugs and antibiotics, improper use of physical methods of lowering and measuring fever, wrong perception of fever as a disease rather than as a symptom or sign of illness misconceptions about its effects on their children's health. 7 The variations found among these studies are possibly due to cultural, economic, geographical, demographic, and educational differences in populations among countries.…”

A systematic review of clinical practice guidelines on the use of low molecular weight heparin and fondaparinux for the treatment and prevention of venous thromboembolism: Implications for research and policy decision-making

“…Across other included CPGs, while domains one ( scope and purpose ) and four ( clarity of presentation ) were particularly well-addressed, domain five ( applicability ), which addresses factors that may impact a guideline’s implementation, potential impact on resources, and strategies to improve uptake, was very poorly addressed. This finding is not unique to this review, rather, it appears to be a general criticism of many reviews of CPGs published on a variety of topics (e.g., breast cancer [ 63 ], osteoarthritis [ 64 ], and childhood fever [ 65 ]). Given that many factors influence the contextualization of scientific evidence for real-world application (i.e., available resources, cost-effectiveness, and availability of services [ 66 ]), future CPGs (and CPG updates) should consider using a validated framework, such as ADAPTE [ 67 ], to systematically integrate important cultural and organizational contexts during development.…”

Systematic reviews of clinical practice guidelines: a methodological guide

“…Only CPGs issued or endorsed by national or international scientific societies and government organizations were included [23,25].…”