Abstract
BackgroundTo ensure that clinical practice guidelines (CPGs) form a sound basis for decision-making in health care, it is necessary to be able to reliably assess and ensure their quality. This results in the need to assess the content of guidelines systematically, particularly with regard to the validity of their recommendations.The aim of the present analysis was to determine the suitability and applicability of frequently used assessment tools for evidence syntheses with regard to the assessment of guideline content.MethodsWe conducted a systematic comparison and analysis of established tools for the assessment of evidence syntheses (guidelines, systematic reviews, health technology assessments). The tools analyzed were: ADAPTE, AGREE II, AMSTAR, GLIA and the INAHTA checklist. We analyzed methodological steps related to the assessment of the reliability and validity of guideline recommendations. Data were extracted and analyzed by two persons independently of one another.ResultsWidely used tools for the methodological assessment of evidence syntheses are not suitable for a comprehensive content-related assessment. They remain mostly at the level of assessment of the documentation of processes. Some tools assess selected content-related aspects, but operationalization is either unspecific or lacking.ConclusionNone of the tools analyzed enables the structured and comprehensive assessment of the content of guideline recommendations with special regard to their reliability and validity. All tools contribute towards the judicious use of evidence syntheses by supporting their systematic development or assessment. However, further progress is needed, particularly with regard to the assessment of content quality. This includes comprehensive operationalization and documentation of the assessment process to ensure reliability and validity, and therefore to enable the effective use of trustworthy guidelines in the health care system.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-0500-7-853) contains supplementary material, which is available to authorized users.
Highlights
To ensure that clinical practice guidelines (CPGs) form a sound basis for decision-making in health care, it is necessary to be able to reliably assess and ensure their quality
According to the current definition by the Institute of Medicine (IOM), clinical practice guidelines (CPGs) “are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options” [1]
Analysis criteria We summarized aspects regarding the assessment of content quality, which are already integral parts of the commonly used assessment tools, and which could form the basis for the development of tools for the assessment of guideline content
Summary
To ensure that clinical practice guidelines (CPGs) form a sound basis for decision-making in health care, it is necessary to be able to reliably assess and ensure their quality This results in the need to assess the content of guidelines systematically, with regard to the validity of their recommendations. According to the current definition by the Institute of Medicine (IOM), clinical practice guidelines (CPGs) “are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options” [1]. In addition to the assessment of the development methods, the current inadequacies result in the need to assess the content of guidelines systematically with regard to the appropriate implementation of methodological standards and to the reliability of their recommendations
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