Systematic Review and Quality Appraisal of Practice Guidelines for Self‐Harm in Children and Adolescents

Abstract

This study aimed to systematically identify and appraise clinical practice guidelines (CPGs) relating to the assessment and management of suicide risk and self-harm in children and adolescents. Our research question is as follows: For young people (under 18 years old) presenting to clinical care with suicide ideation or a history of self-harm, what is the quality of up-to-date CPGs? Using the PRISMA format, we systematically identified CPGs meeting our inclusion and exclusion criteria. Subsequently, two independent raters conducted appraisals of the eligible CPGs using the Appraisal of Guidelines for Research and Evaluation II instrument. CPGs were then classified as "poor quality," "minimum quality," and "high quality" using operationally defined criteria developed a priori. We identified 10 eligible CPGs published or renewed between 2005 and May 2017. Only the long-term management of self-harm CPGs produced by the National Institute for Health and Care Excellence met "high-quality" criteria. Despite multiple options of CPGs published to choose from, only one was identified as "high quality," where bias is adequately minimized. Clinicians are advised to direct resources to implementing the "high-quality" CPG.

Management of physical pain during induced second‐trimester medical abortions: a cross‐sectional study of methodological quality and recommendations in local clinical practice guidelines at Swedish hospitals

“…Moreover, only the author performed the quality assessments, implying a risk of bias. However, the AGREE II instrument has been shown to have adequate levels of validity and reliability , and previous studies indicate high interrater reliability when multiple assessors are used . This, combined with the fact that two separate instruments were used to assess methodological quality, strengthens the findings concerning poor quality.…”

“…No thresholds for scores that would indicate high quality have yet been established . Previous reports suggest that domain scores ≥ 50%–70% indicate high quality and scores <50% indicate low quality . The instrument has shown adequate levels of reliability and validity .…”

Problem-Solving Training as an Active Ingredient of Treatment for Youth Depression: A Scoping Review and Meta-Analysis

“…Relevant empirical studies were searched for pertinent conceptual discussions; reference lists of key studies were searched manually for additional studies; and records citing key studies were searched using Google Scholar (47). For Search B, we included eligible CPGs from a previous review of English-language CPGs published until July 2015 (Search B.1) (48,49). A research librarian reviewed and expanded this search regarding publication language, bibliographic databases, and publication period to align with the parameters for Search A (see Table 1).…”

“…The grey literature search used a multipronged approach to retrieve relevant records from common grey literature databases as well as CPG repositories, and by searching websites of relevant associations, charities, and government agencies (see the supplementary materials). (48,49). CPG had to focus on indicated psychosocial treatments for youth depression, rather than screening and assessment, or psychopharmacological treatment.…”

The Forest and the Trees: Evidence-Based Medicine in the Age of Information

“…In this case, CPGs can still be helpful because they also systematically summarize the input of experts and consumers. Third, it must be admitted that many CPGs in mental health do not use internationally recognized methods to develop their recommendations, 31,32 and the process of searching for and identifying high-quality CPGs can consume a lot time. Fourth, CPGs are often oriented toward a psychiatric diagnosis (eg, depression) as opposed to a presenting symptom (eg, selfharm).…”