Abstract
ObjectiveTo evaluate the quality of clinical practice guidelines (CPGs) for otorhinolaryngology in China.Materials and MethodsA systematic search of relevant literature databases (CBM, WANFANG, VIP, CNKI, China Guideline Clearinghouse) published between 1978 and March 2012 was undertaken to identify and select CPGs related to otorhinolaryngology. Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Their degree of agreement was evaluated using the intraclass correlation coefficient (ICC).ResultFrom 170 citations, 21 relevant guidelines were included. The overall agreement among reviewers was moderate (ICC = 0.87; 95% confidence interval [CI], 0.78–0.91). The scores for each of the AGREE domains were the following: “scope and purpose” (mean ± standard error [SE] = 45.4±4.4; ICC = 0.92), “stakeholder involvement” (mean ± SE = 30.4±3.1; ICC = 0.81), “rigor of development” (mean ± SE = 20.9±2.8; ICC = 0.87), “clarity of presentation” (mean ± SE = 48.8±3.7; ICC = 0.80), “applicability” (mean ± SE = 12.6±1.7; ICC = 0.72), and “editorial independence” (mean ± SE = 6.2±0.8; ICC = 0.76). Three guidelines (14%) mentioned updates, and the average update frequency was 7 years. None used the GRADE system.ConclusionThe quality of otorhinolaryngology guidelines in China is low. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
Highlights
Clinical practice guidelines (CPGs) are defined as ‘‘statements that include recommendations intended to optimize patient care that is informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.’’ [1] The intention of CPGs is to provide clinicians with explicit recommendations on how to manage health conditions and reduce the use of unnecessary, ineffective, or harmful interventions [2]
Clinical practice guidelines are used as a tool for clinicians and patients to make clinical decisions, so using a standardized appraisal instrument to assess the quality of CPGs is very important
The quality of Chinese otorhinolaryngology guidelines published from January 1, 2002, to March 1, 2012, is low but seems comparable to the world average
Summary
Clinical practice guidelines (CPGs) are defined as ‘‘statements that include recommendations intended to optimize patient care that is informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.’’ [1] The intention of CPGs is to provide clinicians with explicit recommendations on how to manage health conditions and reduce the use of unnecessary, ineffective, or harmful interventions [2]. The potential of these CPGs to improve patient care and resource use mainly depends on their quality and the rigor of the guideline development process. Several recent studies found that the methodological quality of clinical guidelines was highly variable. Assessing the quality of CPGs using formal methods is necessary
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