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

Molino, Caroline de Godoi Rezende Costa; Romano-Lieber, Nicolina Silvana; Ribeiro, Eliane; Melo, Daniela Oliveira de

doi:10.1371/journal.pone.0166367

Cited by 29 publications

(66 citation statements)

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“…This study is a complementary analysis of a systematic review and assessment of the methodological quality and transparency of the Brazilian CPGs 14 . This systematic review was registered in PROSPERO.…”

Section: Methods Study Designmentioning

confidence: 99%

“…As previously described 14 , 661 studies were found in the systematic search, of which 26 met the eligibility criteria and were assessed for meth-odological quality and transparency. Details on the studies that were included, excluded, and on the PRISMA checklist can be found in a previously published study 14 .…”

Section: Methods Study Designmentioning

confidence: 99%

“…Medical societies such as the Brazilian Society of Cardiology and the Brazilian Society of Pulmonology also draft and publish CPGs 11,12 . However, concerns have been reported regarding the quality of the Brazilian CPGs 13,14 . Previous studies have found low methodological quality and moderate to low transparency in the Brazilian CPGs 13,14 .…”

Section: Introductionmentioning

confidence: 99%

“…However, concerns have been reported regarding the quality of the Brazilian CPGs 13,14 . Previous studies have found low methodological quality and moderate to low transparency in the Brazilian CPGs 13,14 . Therefore, in this study we compare methodological quality and transparency differences between MoH/Conitec CPGs and those of other Brazilian health institutions to provide evidence to improve CPGs in Brazil.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the methodological quality and transparency of Brazilian practice guidelines

Molino

Romano-Lieber

Ribeiro

et al. 2019

Ciênc. saúde coletiva

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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.

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Section: Methods Study Designmentioning

confidence: 99%

Section: Methods Study Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of the methodological quality and transparency of Brazilian practice guidelines

Molino

Romano-Lieber

Ribeiro

et al. 2019

Ciênc. saúde coletiva

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“…de Molino et al 2016 21. (*) Foi observado significância estatística para "rigor do desenvolvimento" (p = 0,03) e "clareza e apresentação (p = 0,01)".5.3.4.…”

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Estudo da prevalência de competições terapêuticas entre idosos com multimorbidades do estudo SABE (Saúde, Bem-estar e Envelhecimento)

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AGRADECIMENTOS À Deus por sempre ter colocado as pessoas certas na hora certa na minha vida e, por ter me dado saúde e força para seguir meus sonhos. À todas as pessoas que trilharam comigo não somente o desenvolvimento desta tese, mas sim de cada momento que me levou a escolher a vida acadêmica. À Profa. Raquel Marques Braga, que me aceitou como aluna de IC e proporcionou meu primeiro contato com a pesquisa. Às minhas orientadoras de IC, TCC e mestrado, Profa. Priscila Gava Mazzola e Profa.Patricia Moriel, que me aceitaram em seu grupo de pesquisa e possibilitaram que eu realizasse meu sonho de ser farmacêutica clínica. Agradeço ainda à Profa. Priscila por sua amizade, conselhos e apoio durante todos esses anos. À minha orientadora Profa. Eliane Ribeiro que desde a residência tem me orientado e me ensinado tanto. Agradeço ainda à Profa. Eliane pela amizade, confiança no meu trabalho e apoio em todos os momentos. À Profa. Daniela Oliveira de Melo, que me ensinou sobre o cuidado do paciente, pesquisa e trabalho em grupo. Agradeço também à Dani pela parceria nesses anos intensos, pela enorme paciência, amizade e carinho. À Profa. Nicolina Silvana Romano-Lieber, que me ensinou muito sobre docência durante a monitoria e, sempre esteve disponível para me ajudar e dar conselhos valiosos. Agradeço demais à Profa. Nicolina pelas conversas e trocas de mensagens. Aos membros do Chronide por todo empenho e esforço nesses anos e, por facilitarem a elaboração desta tese. Agradeço também à Nathalia Celini Leite Santos e Franciele Cordeiro Gabriel por acreditarem em mim, sempre me incentivando e estando dispostas a ajudar. Ao Prof. Airton Tetelbom Stein que sempre compartilhou seus conhecimentos e contribuiu imensamente com o desenvolvimento desse projeto. À Profa. Valentina Porta pela atenção, conversas e ajuda no ingresso no Programa de Pós-Graduação em Fármaco e Medicamentos. Ao Prof. Humberto Gomes Ferraz por mostrar a importância da participação dos pósgraduandos nas atividades do departamento e nas comissões da faculdade, por incentivar a produção científica e o EPIFAR e, pelas reuniões e transparência sobre o Programa de Pós-Graduação Fármaco e Medicamentos. Aos Professores Yeda Aparecida de Oliveira Duarte, Maria Lúcia Lebrão (in memoriam), Ruy Laurenti (in memoriam) e Jair Lício Ferreira Santos por conduzirem e possibilitarem a existência do Estudo SABE. Agradeço ainda à Profa. Yeda por compartilhar o banco do Estudo SABE, pela disponibilidade e atenção. Aos idosos e toda equipe do Estudo SABE por participarem e viabilizarem o desenvolvimento do Estudo e dessa tese. Aos Professores da pós-graduação do Departamento de Medicina Preventiva, da Faculdade de Saúde Pública e da Faculdade de Ciências Farmacêuticas, que contribuíram na minha formação como pesquisadora. To Prof. Heike A. Bischoff-Ferrari for accepting me as a visitor student. Thank you for being so nice and sharing your knowledge with me. I would like to thank my colleagues from the Zentrum Alter und Mobilität (ZAM), Universität Zürich, for their friendship and...

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Factors Associated With High-Quality Guidelines for the Pharmacologic Management of Chronic Diseases in Primary Care

et al. 2019

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for the Chronic Diseases and Informed Decisions (CHRONIDE) Group IMPORTANCE As the rate of publication of new and sometimes conflicting medical research increases, clinicians rely heavily on clinical practice guidelines (CPGs) to inform practice. However, CPGs are of widely variable quality, and there are no existing objective measures to rate the quality of CPGs.OBJECTIVE To systematically assess 421 CPGs for the management of common noncommunicable diseases in primary care using the validated Appraisal of Guidelines for Research and Evaluation Instrument, version II (AGREE-II) tool and elucidate the factors associated with quality of CPGs.EVIDENCE REVIEW MEDLINE, Embase, the Cochrane Library, and 12 websites for CPGs were searched for CPGs for the management of common noncommunicable diseases in primary care published between January 1, 2011, and August 30, 2017. The assessment of the quality of CPGs was performed by 3 appraisers using the 6 domains of the AGREE-II instrument. A multiple logistic regression was performed to identify factors associated with quality of CPGs.FINDINGS Of the 421 CPGs reviewed, 23.5% (99) were classified as high quality. Among included guidelines, clarity of presentation (70%) and scope and purpose (61%) had the highest median AGREE-II scores. The domains with the lowest median scores were applicability (22%) and rigor of development (33%). Factors associated with high-quality CPGs included having more than 20 authors (odds ratio, 9.08; 95% CI, 3.35-24.62), development at governmental institutions (odds ratio, 10.38; 95% CI, 2.72-39.60), and reporting funding (odds ratio, 10.34; 95% CI,. Year of publication, region, guideline version, and scope were not associated with quality among included CPGs.CONCLUSIONS AND RELEVANCE Primary care professionals and policymakers should be aware that CPGs in primary care are of widely variable quality, with less than 25% of included CPGs rated as high quality. High-quality CPGs were associated with a higher number of authors, governmental institutions, and the report of funding. Region of origin was not associated with quality of CPGs, which suggests that the improvement of the quality of CPGs should be an international concern.

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

Cited by 29 publications

References 51 publications

Comparison of the methodological quality and transparency of Brazilian practice guidelines

Comparison of the methodological quality and transparency of Brazilian practice guidelines

Estudo da prevalência de competições terapêuticas entre idosos com multimorbidades do estudo SABE (Saúde, Bem-estar e Envelhecimento)

Factors Associated With High-Quality Guidelines for the Pharmacologic Management of Chronic Diseases in Primary Care

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