Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review
Abstract Background The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-022-02539-9 |
| _version_ | 1798044508217147392 |
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| author | R. Zambrano-Sánchez P. Alvarez-Mena D. Hidalgo C. M. Escobar Liquitay J. V. A. Franco R. W. M. Vernooij D. Simancas-Racines A. Viteri-García C. Montesinos-Guevara |
| author_facet | R. Zambrano-Sánchez P. Alvarez-Mena D. Hidalgo C. M. Escobar Liquitay J. V. A. Franco R. W. M. Vernooij D. Simancas-Racines A. Viteri-García C. Montesinos-Guevara |
| author_sort | R. Zambrano-Sánchez |
| collection | DOAJ |
| description | Abstract Background The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their methodological quality. Therefore, we aimed to systematically evaluate the quality of CPGs for the diagnosis and treatment of IBD using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Methods We identified CPGs by searching databases (MEDLINE - PubMed, EMBASE, CINAHL, LILACS) and other sources of gray literature on January 2022. We included guidelines with specific recommendations for the diagnosis and treatment of IBD and evaluated them with the AGREE II instrument to assess their methodological quality. Six independent reviewers assessed the quality of the guidelines and resolved conflicts by consensus. We assessed the degree of agreement using the intraclass correlation coefficient (ICC) and change in quality over time was appraised in two periods: from 2012 to 2017 and from 2018 to 2022. Results We analyzed and evaluated 26 CPGs that met the inclusion criteria. The overall agreement among reviewers was moderate (ICC: 0.74; 95% CI 0.36 - 0.89). The mean scores of the AGREE II domains were: “Scope and purpose” 84.51%, “Stakeholder involvement” 60.90%, “Rigor of development” 69.95%, “Clarity of presentation” 85.58%, “Applicability” 26.60%, and “Editorial independence” 62.02%. No changes in quality were found over time. Conclusions The quality of the CPGs evaluated was generally good, with a large majority of the assessed guidelines being “recommended” and “recommended with modifications”; despite this, there is still room for improvement, especially in terms of stakeholder involvement and applicability. Efforts to develop high quality CPGs for IBD need to be further optimized. |
| first_indexed | 2024-04-11T23:05:22Z |
| format | Article |
| id | doaj.art-607ed3e1cc474f71a79f354343142ff0 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-11T23:05:22Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-607ed3e1cc474f71a79f354343142ff02022-12-22T03:58:02ZengBMCBMC Gastroenterology1471-230X2022-11-0122111410.1186/s12876-022-02539-9Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic reviewR. Zambrano-Sánchez0P. Alvarez-Mena1D. Hidalgo2C. M. Escobar Liquitay3J. V. A. Franco4R. W. M. Vernooij5D. Simancas-Racines6A. Viteri-García7C. Montesinos-Guevara8Maestría en Epidemiología con mención en Investigación Clínica Aplicada. Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTEMaestría en Epidemiología con mención en Investigación Clínica Aplicada. Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTEInternal medicine service, NMMC HamiltonResearch Department. Instituto Universitario Hospital Italiano de Buenos AiresInstitute of General Practice, Heinrich-Heine-University DüsseldorfDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCentro de Investigación en Salud Pública y Epidemiologia Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo. Universidad UTECentro de Investigación en Salud Pública y Epidemiologia Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo. Universidad UTECentro de Investigación en Salud Pública y Epidemiologia Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo. Universidad UTEAbstract Background The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their methodological quality. Therefore, we aimed to systematically evaluate the quality of CPGs for the diagnosis and treatment of IBD using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Methods We identified CPGs by searching databases (MEDLINE - PubMed, EMBASE, CINAHL, LILACS) and other sources of gray literature on January 2022. We included guidelines with specific recommendations for the diagnosis and treatment of IBD and evaluated them with the AGREE II instrument to assess their methodological quality. Six independent reviewers assessed the quality of the guidelines and resolved conflicts by consensus. We assessed the degree of agreement using the intraclass correlation coefficient (ICC) and change in quality over time was appraised in two periods: from 2012 to 2017 and from 2018 to 2022. Results We analyzed and evaluated 26 CPGs that met the inclusion criteria. The overall agreement among reviewers was moderate (ICC: 0.74; 95% CI 0.36 - 0.89). The mean scores of the AGREE II domains were: “Scope and purpose” 84.51%, “Stakeholder involvement” 60.90%, “Rigor of development” 69.95%, “Clarity of presentation” 85.58%, “Applicability” 26.60%, and “Editorial independence” 62.02%. No changes in quality were found over time. Conclusions The quality of the CPGs evaluated was generally good, with a large majority of the assessed guidelines being “recommended” and “recommended with modifications”; despite this, there is still room for improvement, especially in terms of stakeholder involvement and applicability. Efforts to develop high quality CPGs for IBD need to be further optimized.https://doi.org/10.1186/s12876-022-02539-9Inflammatory bowel diseaseCrohn diseaseUlcerative colitisClinical practice guidelinesSystematic review |
| spellingShingle | R. Zambrano-Sánchez P. Alvarez-Mena D. Hidalgo C. M. Escobar Liquitay J. V. A. Franco R. W. M. Vernooij D. Simancas-Racines A. Viteri-García C. Montesinos-Guevara Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review BMC Gastroenterology Inflammatory bowel disease Crohn disease Ulcerative colitis Clinical practice guidelines Systematic review |
| title | Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review |
| title_full | Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review |
| title_fullStr | Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review |
| title_full_unstemmed | Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review |
| title_short | Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review |
| title_sort | quality assessment of clinical practice guidelines cpg for the diagnosis and treatment of inflammatory bowel disease using the agree ii instrument a systematic review |
| topic | Inflammatory bowel disease Crohn disease Ulcerative colitis Clinical practice guidelines Systematic review |
| url | https://doi.org/10.1186/s12876-022-02539-9 |
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