838 Quality Assessment of Clinical Practice Guidelines (CPGs) for the Diagnosis and Treatment of Inflammatory Bowel Disease

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD) comprises Crohn's Disease (CD) and Ulcerative Colitis (UC), which are chronic disorders characterized by inflammation of the gastrointestinal (GI) tract. IBD is caused by a combination of genetic and environmental factors and a deregulated immune system. While UC comprises a diffuse mucosal inflammation of the large bowel, CD presents as a patchy and transmural inflammation. The severity of IBD varies over time and urgent medical care is required when complications arise. Thus, clinical practice guidelines (CPGs) for IBD diagnosis and treatment have been created and updated over time. To our knowledge, only one study has assessed CPGs' quality for IBD, which were published in Japanese. The aim of this revision is to evaluate current CPGs for IBD diagnosis and treatment so healthcare professionals and patients can benefit from it. METHODS: We performed a systematic search in databases including Medline, Embase, CINAHL, Lilacs, NICE, SIGN, ACG, AGA, Portuguese Gastroenterology Society, and Australian Gastroenterology Society. Two reviewers were calibrated for the inclusion of CPGs by screening the same 25% of total records by title and abstract (Tiab), the Intraclass Correlation Coefficient (ICC) between reviewers was 0.7. The remaining 75% of total records was divided between the two reviewers, who independently assessed them. A similar process was performed for full-text assessment obtaining an ICC of 0.8. If reviewers disagreed, a third reviewer was involved and conflicts were solved by discussion. The authors using the AGREE II tool will evaluate all included CPGs. RESULTS: 5134 records were retrieved and 5042 remained after de-duplication. 106 records were included after Tiab screening for full-text assessment and 16 CPGs were included for data extraction. According to the data obtained from the 16 included CPGs, they were published in English, Spanish, Japanese, German and Korean. 6 CPGs were focused on UC alone, 7 were focused on CD, and 3 addressed IBD. Moreover, the 16 CPGs were developed in Israel (4), Germany (1), Japan (1), Mexico (2), Canada (1), USA (2), South Korea (1) UK (1), Spain (1), and Multiple countries (2). CPGs' developers include: Professional Association/Society (7), University (3), Government (1), and International Organization (5). CONCLUSION: This evaluation of 16 CPGs for the diagnosis and treatment of IBD contributes to a better understanding of the quality of evidence-based clinical recommendations.