Abstract
ObjectiveTo systematically evaluate the quality of clinical practice guidelines (CPG) for medically treating benign prostatic hyperplasia (BPH), and to compare the context of recommendations in order to provide references for clinical application.MethodsWe searched databases of National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN) and World Health Organization (WHO), PubMed, Embase, CNKI, VIP, WanFang Data, CBM, and Medlive from their establishment to October 13, 2019, to collect evidence-based guidelines and/or consensus on BPH. Method quality of included guidelines was assessed according to the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and differences and similarities among recommendations were compared.ResultsA total of 22 guidelines were included, of which eight were updated versions. According to the AGREE II instrument, the median score of scope and purpose, stakeholder involvement, rigor of formulate, clarity of presentation, applicability, and editorial independence was 71.5%, 41%, 25%, 64%, 18%, and 28%, respectively. Based on recommendations for medical treatment, almost all guidelines recommended α1-blockers and 5α-reductase inhibitors, and most guidelines also recommended muscarinic receptor antagonists. In terms of drug combination therapy, most guidelines recommended “α1 blockers and 5α-reductase inhibitors”, and some guidelines also recommended “α1 blockers and muscarinic receptor antagonists”.ConclusionThe recommendations from different guidelines were basically similar, only showing conflicts in some areas. The quality of included guidelines remains to be unified, and their context can provide valuable implications for development or improvement.
Highlights
A meta-analysis on studies from 25 countries showed that the lifetime prevalence of BPH was 26.2% [95% confidence interval (CI): 22.8–29.6%] and there were no regional or ethnic differences (Lee et al, 2017)
Computer searched National Library of the United States (NGC), Guideline International Network (GIN), National Institute of Health and Clinical Demonstration (NICE), English Inter-Institutional Guide Network (SIGN), World Health Organization (WHO), PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database, China Biomedical Literature Data Road, and Medlive website from their inception to October 20, 2019, and a manual retrieval was performed for relevant literature references
This study aimed to evaluate the quality of Clinical Practice Guide (CPG) for BPH worldwide
Summary
A meta-analysis on studies from 25 countries showed that the lifetime prevalence of BPH was 26.2% [95% confidence interval (CI): 22.8–29.6%] and there were no regional or ethnic differences (Lee et al, 2017). The development and continuous updating of the BPH Clinical Practice Guide (CPG) (Wang, 2016) impose a positive impact on promoting the standardization of clinical medical work. Many countries, especially developed ones, have made great achievements in the development and application of BPH diagnosis and treatment guidelines in order to solve many problems faced in BPH clinical practice (Novara et al, 2006). Despite this progress, the quality of many CPG still appeared to fall below desirable standards. Focused on the content of drug treatment for BPH guidelines, hoping to provide help for frontline clinicians when referring to the guidelines, and hoping to provide references for the specification of evidence-based guidelines for clinical treatment
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