Quality assessment of clinical practice guidelinesfor Chagas disease

Abstract

Introduction:The development of clinical practice guidelines (CPGs) has increased; this study aimed to assess the quality of CPGs for the management of Chagas disease. Methods: Following a systematic search of the scientifi c literature, two reviewers assessed the eligible guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) II instrument. Results: Five CPGs were included. The AGREE domains of scope/purpose, stakeholder involvement, and clarity of presentation were rated well, and the domains of applicability and editorial independence received poor ratings. Conclusions: The quality of CPGs for Chagas disease is poor, and signifi cant work is required to develop high-quality guidelines.

Therapeutic drug monitoring of benznidazole and nifurtimox: a systematic review and quality assessment of published clinical practice guidelines

“…It indicates that more efforts are needed to improve these CPGs, especially with respect to the domain of rigor of development, which is considered to be crucial for the guideline quality and to determine whether the recommendations are really based on evidence. In order to establish evidencebased recommendations and clinically valid in all CPGs, developers should implement systematic methods for rating quality of evidence and strength of recommendations 24 . This fi nding is similar to a study of 42 reviews of CPGs of healthcare topics published, which showed that despite some increase in quality of CPGs over time, the quality scores as measured with the AGREE Instrument have remained moderate to low over the last two decades 25 .…”

The continuous challenge of Chagas disease treatment: bridging evidence-based guidelines, access to healthcare, and human rights

“…In addition, the best strategies for comprehensive care in the specifi c contexts of the countries must be provided for the people affected 4,9 . Besides the parasitological treatment, other aspects of care are fundamental to ensuring quality of life in people affected and must be evaluated.…”

“…Thus, the development of national guidelines for care, surveillance, and control of Chagas disease becomes a challenging task, dependent on the efforts of health professionals, researchers, and social movements 9 . The challenge of sustaining Chagas disease on the agenda of the national governments and the society has become a daily struggle 1 .…”

“…Other countries, such as Bolivia, Colombia, and Argentina are in the process of developing new adjusted national guidelines for Chagas disease 5,8 . In addition to the initial non-availability of evidence-based guidelines, there was also a lack of minimum standardization between and within the different countries, which created even greater obstacles for an integrated global response 9,10 .…”

“…Signifi cant differences were found on the pharmacological management, duration of treatment, standards of clinical controls, and the role of laboratory tests 10 . These differences can impact the access to health care contributing to worse health outcomes 9,10 . Some national strategies have been developed in endemic countries as a solution to unmet demands in improving access to Chagas disease diagnosis and treatment 1,9 .…”