Assessment of the quality of recommendations from 161 clinical practice guidelines using the Appraisal of Guidelines for Research and Evaluation-Recommendations Excellence (AGREE-REX) instrument shows there is room for improvement
Florez, Ivan D. (McMaster University (Canadà))
Brouwers, Melissa C. (University of Ottawa)
Kerkvliet, Kate (McMaster University (Canadà))
Spithoff, Karen (McMaster University (Canadà))
Alonso-Coello, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Burgers, Jako (Dutch College of General Practitioners)
Cluzeau, Francoise (St. Mary's Hospital)
Férvers, Beatrice (Centre Léon Bérard (França))
Graham, Ian (University of Ottawa)
Grimshaw, Jeremy (University of Ottawa)
Hanna, Steven (McMaster University (Canadà))
Kastner, Monika (North York General Hospital (Toronto, Canadà))
Kho, Michelle (Institute of Applied Health Sciences McMaster University)
Qaseem, Amir (American College of Physicians)
Straus, Sharon (Li Ka Shing Knowledge Institute of St. Michael's Hospital)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	To assess the quality of recommendations from 161 clinical practice guidelines (CPGs) using AGREE-REX-D (Appraisal of Guidelines REsearch and Evaluation-Recommendations Excellence Draft). International CPG community. Three hundred twenty-two international CPG developers, users, and researchers. Participants were assigned to appraise one of 161 CPGs selected for the study using the AGREE-REX-D tool Main outcome measures: AGREE-REX-D scores of 161 CPGs (7-point scale, maximum 7). Recommendations from 161 CPGs were appraised by 322 participants using the AGREE-REX-D. CPGs were developed by 67 different organizations. The total overall average score of the CPG recommendations was 4. 23 (standard deviation (SD) = 1. 14). AGREE-REX-D items that scored the highest were (mean; SD): evidence (5. 51; 1. 14), clinical relevance (5. 95; SD 0. 8), and patients/population relevance (4. 87; SD 1. 33), while the lowest scores were observed for the policy values (3. 44; SD 1. 53), local applicability (3,56; SD 1. 47), and resources, tools, and capacity (3. 49; SD 1. 44) items. CPGs developed by government-supported organizations and developed in the UK and Canada had significantly higher recommendation quality scores with the AGREE-REX-D tool (p < 0. 05) than their comparators. We found that there is significant room for improvement of some CPGs such as the considerations of patient/population values, policy values, local applicability and resources, tools, and capacity. These findings may be considered a baseline upon which to measure future improvements in the quality of CPGs.
Drets:	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.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	AGREE tool ; Clinical practice guidelines ; Implementability ; Practice guidelines ; Quality of health care ; Recommendations
Publicat a:	Implementation Science, Vol. 15 Núm. 1 (18 2020) , p. 79, ISSN 1748-5908

DOI: 10.1186/s13012-020-01036-5
PMID: 32948216

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