Methodological Rigour and Transparency of Clinical Practice Guidelines Developed by Neurology Professional Societies in Croatia

Abstract

BackgroundClinical practice guidelines are systematically created documents that summarize knowledge and assist in delivering high-quality medicine by identifying evidence that supports best clinical care. They are produced not only by international professional groups but also by local professionals to address locally-relevant clinical practice. We evaluated the methodological rigour and transparency of guideline development in neurology formulated by professionals in a local medical community.MethodsWe analyzed clinical guidelines in neurology publicly available at the web-site of the Physicians’ Assembly in Croatia in 2012: 6 guidelines developed by Croatian authors and 1 adapted from the European Federation of Neurological Societies. The quality was assessed by 2 independent evaluators using the AGREE II instrument. We also conducted a search of the Cochrane Library to identify potential changes in recommendation from Cochrane systematic reviews included in guideline preparation.ResultsThe methodological quality of the guidelines greatly varied across different domains. „Scope and Purpose” and „Clarity of Presentation“ domains received high scores (100% [95% confidence interval (CI) 98.5–100] and 97% [77.9–100], respectively), the lowest scores were in “Stakeholder Involvement“ (19% [15.5–34.6]) and “Editorial Independence” (0% [0–19.2]). Conclusions of 3 guidelines based on Cochrane systematic reviews were confirmed in updated versions and one update provided new information on the effectiveness of another antidepressant. Two Cochrane reviews used in guidelines were withdrawn and split into new reviews and their findings are now considered to be out of date.ConclusionNeurological guidelines used in Croatia differ in structure and their methodological quality. We recommend to national societies and professional groups to develop a more systematic and rigorous approach to the development of the guidelines, timely inclusion of best evidences and an effort to involve target users and patients in the guideline development procedures.

Reporting quality of European and Croatian health practice guidelines according to the RIGHT reporting checklist

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Clinical practice guidelines for the management of neuropathic pain: a systematic review

“…A score of 7 (strongly agree) should be assigned when the full criteria and considerations articulated in User’s Manual have been met. A score between 2 and 6 should be given if reporting information does not meet the full criteria or considerations relevant to the AGREE II item [ 26 ]. Three reviewers assessed each included CPG independently and provided their scores on the overall assessment.…”

Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency

“…For instance, the Appraisal of Guidelines Research and Evaluation instrument [21] version II (AGREE II), published in 2009, has been extensively used, validated in several languages, and covers essential information for comprehensive CPG evaluation [19,20]. Several studies worldwide have been conducted for assessing CPG quality using the AGREE II [9–11,16–18,22–25]; however, very little is known regarding CPG quality among low income countries [10]. To date, only one study has evaluated CPG quality in Brazil [18], and none have critically assessed CPGs for NCD treatment quality within a Brazilian sample.…”