Methodological transparency of preoperative clinical practice guidelines for elective surgery. Systematic review
Angel, Gustavo (Universidad del Cauca (Cauca, Colòmbia). Departamento de Anestesiología)
Trujillo, Cristian (Universidad del Cauca (Cauca, Colòmbia). Departamento de Anestesiología)
Mallama, Mario (Universidad del Cauca (Cauca, Colòmbia). Departamento de Anestesiología)
Alonso-Coello, Pablo (Institut de Recerca Sant Pau)
Klimek, Markus (Erasmus University Medical Centre Rotterdam. Department of Anesthesiology)
Calvache, Jose A. (Erasmus University Medical Centre Rotterdam. Department of Anesthesiology)
Universitat Autònoma de Barcelona

Fecha:	2023
Resumen:	Clinical practice guidelines (CPG) are statements that provide recommendations regarding the approach to different diseases and aim to increase quality while decreasing the risk of complications in health care. Numerous guidelines in the field of perioperative care have been published in the previous decade but their methodological quality and transparency are relatively unknown. To critically evaluate the transparency and methodological quality of published CPG in the preoperative assessment and management of adult patients undergoing elective surgery. Systematic review and methodological appraisal study. We searched for eligible CPG published in English or Spanish between January 1, 2010, and June 30, 2022, in Pubmed MEDLINE, TRIP Database, Embase, the Cochrane Library, as well as in representatives' medical societies of Anaesthesiology and developers of CPG. CPG dedicated on preoperative fasting, cardiac assessment for non-cardiac surgery, and the use of routine preoperative tests were included. Methodological quality and transparency of CPG were assessed by 3 evaluators using the 6 domains of the AGREE-II tool. We included 20 CPG of which 14 were classified as recommended guidelines. The domain of "applicability" scored the lowest (44%), while the domains "scope and objective" and "editorial interdependence" received the highest median scores of 93% and 97% respectively. The remaining domains received scores ranging from 44% to 84%. The top mean scored CPG in preoperative fasting was ASA 2017 (93%); among cardiac evaluation, CPG for non-cardiac surgery were CCS 2017 (91%), ESC-ESA 2014 (90%), and AHA-ACC 2014 (89%); in preoperative testing ICSI 2020 (97%). In the last ten years, most published CPG in the preoperative assessment or management of adult patients undergoing elective surgery focused on preoperative fasting, cardiac assessment for non-cardiac surgery, and use of routine preoperative tests, present moderate to high methodological quality and can be recommended for their use or adaptation. Applicability and stakeholder involvement domains must be improved in the development of future guidelines.
Nota:	Altres ajuts: Erasmus Universitair Medisch Centrum Rotterdam ; Universidad del Cauca
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	PloS one, Vol. 18 (february 2023) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0272756
PMID: 36827452

14 p, 1.6 MB

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