Objective To evaluate the methodological quality and reporting quality of clinical guidelines and consensus on central venous catheters. Methods The PubMed, EMbase, Web of Science, CBM, WanFang Data, CNKI databases and Guidelines International Network, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Medive.cn websites were searched to collect clinical guidelines and consensus related to central venous catheters. The retrieval time was from the establishment of the database to October 2022. Two researchers independently screened the literature, extracted data and used evaluation tools AGREE Ⅱ and RIGHT to evaluate the quality of the included studies. Results A total of 34 central venous catheter guidelines and consensus were included. The average score for each field of AGREE II was 53.73% for scope and purpose, 39.26% for participants, 39.57% for rigor, 46.76% for clarity, 30.23% for application and 49.18% for editorial independence. Items 1a, 1b, 3, and 4 (100.00%) had the highest reporting rate in the RIGHT evaluation items, followed by items 19a (97.05%), 2/19b (94.11%), 20 (91.17%), 7b/11a (88.23%), and 7a (85.29%). The reporting rate of the remaining items was below 60%. Subgroup analysis results showed that the average score and RIGHT score of the guidance class in the four fields of AGREE Ⅱ (rigor, clarity, application and editorial independence) were higher than those of the consensus class. Guidelines and consensus formulated based on evidence-based medicine methods were higher than those formulated based on expert opinions or reviews in the three fields of AGREE II (rigor, application and editorial independence). The average scores of foreign guidelines and consensus in 6 fields and RIGHT scores of AGREE Ⅱ were higher than those of domestic guidelines and consensus. Conclusion The AGREE Ⅱ of 6 fields average score and RIGHT score in foreign guidelines are higher than those in domestic guidelines.
ObjectivesTo evaluate the methodological quality of guidelines for pharmacological intervention of migraine in adults, to compare and analyze the differences in first-line drug recommendations in different regions and quality levels, so as to explore the evidence of drug recommendations, and provide a basis for clinical decision-making.MethodsPubMed, The Cochrane Library, EMbase, SinoMed, CNKI, VIP, and WanFang Data databases, Up To Date, as well as the related books, Yimaitong, Guideline Central, Guidelines International Network (GIN) and National Institute for Health and Clinical Excellence (NICE) were systematically searched to collect pharmacological intervention guidelines of migraine in adults from inception to January 12th, 2020. The methodological quality of the guidelines was evaluated by Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ).ResultsA total of 25 guidelines were included (including 22 evidence-based guidelines), covering 10 countries on 4 continents and World Health Organization (WHO) with a time span of 1997 to 2019. According to AGREE Ⅱ, 5 were A-level guidelines, 18 were B-level guidelines, and 2 were C-level guidelines. Scope and purpose, rigour of development, clarity of presentations and editorial independence obtained high average scores (more than 60%) among all 25 guidelines. The average scores of guidelines in different domains of AGREE Ⅱ varied with regions and countries. Triptans and NSAIDs were the most frequently recommended as first-line drugs for the acute management; beta-blockers and antiepileptic drugs were recommended for the first-line prevention drugs of migraine in adults. There were 2 guidelines that recommended complementary treatments, one recommended traditional Chinese medicine and another recommended herbal butterbur.ConclusionsThe methodological quality of the pharmacological intervention guidelines of migraine in adults is suboptimal among different regions or countries. The quality of evidence-based guidelines is superior to that established by consensus. The consistency of first-line drug recommendations is strong, but there are still regional differences. The therapeutic effect of traditional Chinese medicine requires further verification.
Using the AGREE Ⅱ standard, this paper interpretated from methodological perspective of the Korean Guidelines for Appropriate use of cardiac CT which was made by Korean Society of Radiology and the Korean Society of Cardiology.
ObjectivesTo evaluate the methodological quality of clinical practice guidelines (CPGs) of Chinese rehabilitation medicine.MethodsCBM, VIP, CNKI, WanFang Data and Medlive databases were electronically searched to collect CPGs of Chinese rehabilitation medicine from January 1979 to May 2018. Four reviewers evaluated the methodological quality of the CPGs by AGREE Ⅱ.ResultsA total of 11 CPGs were included, which involved 5 CPGs on nervous system rehabilitation, 1 CPG on bone and joint system rehabilitation, 1 CPG each on pediatric rehabilitation, internal medicine system rehabilitation, burn rehabilitation, earthquake rehabilitation and rehabilitation diagnosis and treatment criteria respectively. The results of AGREE Ⅱ score showed that the average scores on six domains were 65.3%, 28.0%, 9.3%, 42.1%, 6.3% and 4.0%. There were not any level A (recommended) guidelines. Two guidelines were level B (recommended after being revised). The other nine guidelines were level C (not recommended).ConclusionsThere are a few rehabilitation CPGs in China and the quality of methodology is low. AGREE's methods and concepts have not been fully used for formulation. The rigor of development, clarity of presentation, applicability and editorial independence of guidelines should be emphasized, so as to produce high level CPGs and improve clinical practice quality in rehabilitation medicine.
ObjectivesTo systematically review the methodological and reporting quality of the current global breast cancer screening guidelines so as to provide useful information for domestic study in the future.MethodsWe searched databases including PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, CBM, WanFang Data and some cancer official websites to collect breast cancer screening guidelines from inception to February, 2018. Two reviewers independently screened literature, extracted data and assessed the quality of the guidelines by using AGREE II tool and RIGHT statement.ResultsA total of 11 guidelines were included, in which 5 guidelines (45%) were issued by the USA. The results of the quality assessment showed that: the average scores in the " scale and objective”, " participants”, " rigorism”, " clarity”, " application”, and " independence” of all guidelines were 83, 48, 60, 77, 53 and 79, respectively. 6 guidelines were evaluated as level A and 5 as level B. For the reporting quality, 3 guidelines were of high quality, including 2 in the USA and 1 in Canada.ConclusionsThe methodological and reporting quality of breast cancer screening guidelines are at present very satisfactory. The quantity of clinical guidelines shows an increasing trend. Multi-country contribution to one guideline is another trend. The evidence-based methodology has been accepted globally in the guideline development.
ObjectiveTo evaluate the quality, status of clinical practice guidelines on stomatology in China and discuss existing problems, so as to provide references for developing evidence-based guidelines. MethodsComprehensive search was conducted up to January 2014 for relevant clinical practice guidelines on stomatology, and the retrieval date was January 30th, 2014. After data extraction from eligibility guidelines, the quality was evaluated using the AGREE Ⅱ instrument and then descriptive analysis was performed. ResultsFinally a total of 18 guidelines were included, of which, 13 were for oral and maxillofacial surgery diseases. Based on the AGREE Ⅱ instrument, the average scores on the six domains were as follows:71.1% for scope and purpose, 40.1% for stakeholder involvement, 28.8% for rigor of development, 71.5% for clarity of presentation, 42.6% for applicability, and 8.6% for editorial independence. ConclusionThe overall quality of clinical practice guidelines on stomatology in China is relatively poor, only a few diseases are concerned, and no evidence-based guideline has been developed so far. However, considered the limitations of this study, the results of this study is only for a reference.
Objective To assess the methodological quality of pediatric COVID-19 guidelines using the AGREE Ⅱ. Methods Domestic and foreign pediatric COVID-19 guidelines from inception to 1st Oct 2021 were electronically searched in PubMed, CBM, CNKI, VIP, WanFang Data, Medlive, NGC, GIN, and NICE databases and relevant websites. Two researchers independently assessed the methodological quality of the guidelines by using AGREE Ⅱ. Results A total of 21 guidelines were included. The AGREE Ⅱ results revealed that the average scores of included guidelines in 6 domains (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence) were 62.70%, 36.24%, 20.34%, 50.42%, 22.12% and 53.17%, respectively. ConclusionThe methodological quality of pediatric COVID-19 guidelines is poor. Guideline developers should follow the requirements of AGREE Ⅱ in guideline development.
ObjectivesTo evaluate the methodological and reporting quality of clinical guidelines and consensus for esophageal cancer.MethodsDatabases including PubMed, EMbase, Web of Science, CBM, WanFang Data and CNKI were electronically searched and major guideline websites such as GIN, NICE, NGC and Yimaitong were also searched to collect guidelines and consensus for esophageal cancer from inception to August 2018. Two reviewers independently screened the literatures and extracted data according to the inclusion and exclusion criteria and then evaluated the quality of the included guidelines using the AGREE II and RIGHT instruments.ResultsA total of 26 esophageal cancer guidelines and consensus were included. The mean scores for each domain of AGREE II was 49.63% for scope and purpose, 25.16% for stakeholder involvement, 23.42% for rigor of development, 49.25% for clarity of presentation, 16.91% for applicability, and 21.07% for editorial independence. The item with the highest reporting rate among the RIGHT evaluation items was 5 (84.62%), followed by 1a (80.77%), 1c (65.38%), 13a (65.38%), and 4 (61.54%), and the remaining items were all reported below 50%. Results of subgroup analysis showed that the guidelines and consensus developed based on the evidence-based medicine method had higher average scores in the six domains of AGREE II and the RIGHT score than the guidelines and consensus developed based on expert opinions or reviews. The foreign guidelines and consensus had higher average scores in the three domains of AGREE II (formulation rigor, clarity, editorial independence) and the RIGHT score than the domestic guidelines.ConclusionsThe methodological and reporting quality of the guidelines and consensus on esophageal cancer is low, with the guidelines and consensus in China even lower, requiring further improvement. It is suggested that the guideline developers should refer to the standards such as AGREE II and RIGHT to develop high-quality guidelines and promote their application, so as to better guide the standardized diagnosis and treatment of esophageal cancer.
ObjectiveTo review guidelines on diet intervention for hypertension, compare the similarities/differences and the regularity of the guidelines, discuss the prevention and treatment effects of diet intervention for hypertension, promote the understanding of the guide, and to explore the best method of diet intervention for hypertension. MethodsDatabase such as CNKI, EMbase, PubMed, etc., as well as guideline websites were searched from inception to February 28th, 2014, for collecting guidelines on diet intervention in the prevention and treatment of hypertension. The Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ) were applied to assess methodological quality of the guidelines. Characteristics of diets recommended by the guidelines were analyzed through comparing the different regions and quality levels of the guidelines. ResultsA total of 27 guidelines on diet intervention for hypertension were included. They were formulated by 5 continents, 9 countries, 2 regions (Taiwan of China and Europe), and 1 international organization (WHO). According to the AGREE Ⅱ instrument, 13 guidelines were graded as Level A (recommendation) and 14 were graded as Level B (recommended after changes), respectively. The domains were more than 60% except for "rigor of development" (57.89±7.71)% and "applicability" (58.39±6.29)%. Each guideline recommended low sodium diet (usually:5 to 6 g/d; Oceania:4 g/d; North America:the amount of sodium intake should be decreased as age increases). The amount of alcohol intake was generally 30 mL/d for men and 20 mL/d for women. All included guidelines recommended to increase the intake of fruits, vegetables, and potassium. ConclusionCurrently, more than half of diet intervention recommendations for hypertension in different countries and regions are still needs to be improved and modified. Diet recommendations differ in regions, gender, and age.
Objective To evaluate the methodological and reporting quality of clinical guidelines and consensus for adult AIDS. Methods Databases including PubMed, EMbase, Web of Science, CBM, WanFang Data and CNKI were electronically searched and major guideline websites such as GIN, NICE, NGC and Yimaitong were also searched to collect guidelines and consensus for adult AIDS from inception to December 2021. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. Four reviewers evaluated the methodological and reporting quality of the included guidelines and consensus by using AGREE Ⅱ and RIGHT, respectively. Results A total of 17 adult AIDS guidelines and consensus were included. The average scores of AGREE Ⅱ in various domains were 59.48% for scope and purpose, 37.17% for stakeholder involvement, 30.76% for rigor of development, 74.75% for clarity of presentation, 35.54% for applicability, and 50.49% for editorial independence. The items with the highest reporting rate among the RIGHT evaluation items were 1a, 1b and 1c (100.00%), followed by 3 and 4 (94.12%), 13a and 13b (88.24%), 7b and 11a (76.47%), and 5 (64.71%), and the remaining items were all reported below 60%. Results of subgroup analysis showed that the clarity of presentation, applicability and editorial independence of the guidelines for adult AIDS expressed in AGREE Ⅱ and the average score of RIGHT were higher than those of the consensuses for adult AIDS; the average scores of guidelines and consensuses based on evidence-based medicine in five domains of AGREE Ⅱ (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation and applicability) and RIGHT were higher than those based on expert opinions or reviews. The foreign guidelines and consensus had higher average scores in the six domains of AGREE Ⅱ and the RIGHT score than the domestic guidelines. Conclusion The methodological quality and reporting quality of the published clinical guidelines and consensuses for adult AIDS is low; in particular, there is a certain gap between the national and international guidelines and consensuses. It is suggested that future guideline developers should refer to international standards, such as AGREE Ⅱ and RIGHT, formulate high-quality guidelines and promote their application to better regulate the diagnosis and treatment of adult AIDS.