Critical appraisal of multiple sclerosis guideline in Indonesia

Rizaldy Taslim Pinzon,Sanyasi Rosa De Lima Renita

doi:10.30574/gscbps.2018.5.2.0099

Abstract

Multiple sclerosis (MS) is an autoimmune disease and an incurable. The MS guideline is available in Indonesia. The guideline was developed by Indonesian Neurological Association. The appraisal of these guideline is not yet performed. The aim of this study is to assess the quality of multiple sclerosis guidelines in Indonesia using Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The search was obtained to identify MS guideline in Indonesia. The guideline assessed using AGREE II instrument. There are 23 key items organized within 6 domains and each key items were rated on a 7-point scale. After calculating each domain, the result interpreted as: (i) a strongly recommended for use in practice, (ii) recommended for use with some modification, or (iii) not recommended for use in practice. There was only one MS guideline in Indonesia, developed by Indonesian Neurological Association called “Perdossi” in 2015. Most of the domain score percentage were more than 50%. Domain 4 got the highest score percentage (94.44%), followed by domain 2 (88.89%), domain 1 (83.33%), and domain 5 (54.17%). The guideline had a spesific recommendations and easily identifiable in an algorithms, tables, or summary boxes. The guideline’s objectives, target populations, target users, and development group were clearly described. The lowest score percentage was domain 6 (33.33%) because lack of related informations. Critical appraisal of the Indonesian MS guideline using AGREE II instrument showed a good result. The Indonesian MS guideline was strongly recommended for use in practice.

Highlights

Multiple sclerosis (MS) is an autoimmune disease, a chronic, debilitating, neurodegenerative disease that has a high impact on patients’ quality of life [1,2]
There are some techniques to aid in diagnosis, including: magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and the use of evoked potentials (EP) [9]
Guidelines from Indonesia show a specific recommendation for each conditions

Summary

Introduction

Multiple sclerosis (MS) is an autoimmune disease, a chronic, debilitating, neurodegenerative disease that has a high impact on patients’ quality of life [1,2]. MS attacks people from age 15 to 45 years, with the peak age of onset is 29 years [5]. The cause is unknown, but it appears to involve a combination of genetic susceptibility and a nongenetic trigger, such as a virus, metabolism, or environmental factors, that together result in a self-sustaining autoimmune disorder that leads to recurrent immune attacks on the CNS [7]. Diagnostic criteria for multiple sclerosis (MS) include clinical and paraclinical laboratory assessments. There are some techniques to aid in diagnosis, including: magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and the use of evoked potentials (EP) [9]

Objectives

Methods

Results