Practice Guidelines In Healthcare Research Articles

Quality assessment of guidelines for the management of Mycobacterium tuberculosis infection in children.

OBJECTIVE: The quality of paediatric clinical practice guidelines (CPGs) for the management of Mycobacterium tuberculosis infection is unclear. We aimed to comprehensively assess the quality of these CPGs and identify areas requiring improvement.DESIGN: CPGs were systematically searched and identified before being appraised by independent reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and Reporting Items for Practice Guidelines in HealThcare (RIGHT) tools. Inter-rater reliability was assessed using intra-class correlation coefficient (ICC).RESULTS: Twenty-five CPGs were evaluated. All CPG agreements among four reviewers were good (ICC 0.753-0.939). The mean CPG score was 50.5% (23.5-78.4%), and seven CPGs were recommended for use. The mean scores of three domains were low: 38% for stakeholder involvement (5.6-93.1%), 38.4% for rigour of development (1-97.4%) and 36.3% for applicability (12.5-64.6%). The mean reporting rate of Reporting Items for Practice Guidelines in HealThcare fields was 41.8%, and the evidence field had the highest reporting rate (63.1%), while the review and quality assurance field had the lowest rate (15.4%) for CPGs that include methods.CONCLUSION: The methodological and reporting quality of the CPGs was variable and poor, respectively. More effort is needed in stakeholder involvement, rigour of development, applicability domains and reporting to produce higher-quality CPGs.

2020 Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus

Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. In 2019, under the leadership of the Chinese Rheumatology Association, a multidisciplinary guideline development group was established. The objective was to develop an evidence-based diagnosis and treatment guideline for SLE in China based on emerging new evidence. The guideline was registered at International Practice Guidelines Registry Platform (IPGRP-2019CN022). The grading of recommendations assessment, development and evaluation (GRADE) approach was used to rate the quality of evidence and the strength of recommendations, and the RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist was followed to report the guideline. The guideline provides recommendations for the SLE classification criteria, disease activity monitoring and assessing, medication principles and considerations organ and system involvement and management of patients during pregnancy. This guideline is intended to serve as a tool for Chinese clinicians for the best decisions-making on diagnosis and treatment of SLE.

Evaluation of the Clarity and Completeness of Reporting in Orthopedic Clinical Practice Guidelines.

Clinical practice guidelines (CPGs) can positively affect the quality of patient care offered by physicians because they decrease variability in clinical practice and may help reduce unnecessary testing, promoting a more responsible use of resources. Building on existing framework for reporting guideline development, including the work of the Enhancing the Quality and Transparency of Health Research Network, the Reporting Items for Practice Guidelines in Healthcare (RIGHT) Working Group created a 2016 checklist of 35 items considered essential for high-quality reporting of CPGs. To evaluate how many previously published CPGs in orthopedic surgery met the RIGHT criteria and assess how improvements can be made in future orthopedic CPGs based on any found deficiencies. All 18 CPGs published before January 1, 2018, by the American Academy of Orthopedic Surgeons (AAOS) are publicly available on orthoguidelines.org. Two authors downloaded each file and both of those authors independently scored each CPG using piloted abstraction RIGHT checklist forms. Of the 35 RIGHT criteria outlined in 22 checklist items, 23 (65.7%) were met across all AAOS guidelines, 6 (17.1%) were not met by any of the AAOS guidelines, and 6 (17.2%) were met by some of the AAOS guidelines. Overall, the AAOS guidelines addressed many important recommendations within the RIGHT checklist. Assessing adherence to the RIGHT checklist can help ensure that future guidelines are more effectively communicated, hopefully assisting end users in efficient implementation and increasing the level of evidence-based patient care.

Reporting quality of chronic kidney disease practice guidelines according to the RIGHT statement: a systematic analysis.

Aim:The aim of this study was to evaluate the reporting quality of chronic kidney disease (CKD) guidelines.Methods:PubMed, EMBASE, and guideline-related websites were searched from 2008 to 2019. The CKD guidelines were included. Two reviewers used the RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist to assess the quality of guidelines and calculate the reporting proportion of each guideline.Results:We included 13 guidelines, of which 30.8% (4/13) were developed in Europe and about two-thirds (8/13) were published on their own website. The average quality of the 13 guidelines was 68.57%. The reporting proportion of the seven domains (i.e. basic information; background; evidence; recommendations; review and quality assurance; funding and declaration and management of interests; other information) were 65.39%, 81.73%, 63.08%, 69.23%, 53.85%, 63.46%, and 61.54%, respectively.Conclusion:CKD guidelines had moderate reporting quality in some domains, but guideline developers should increase the reporting items in basic information, guideline evidence, and recommendations. The RIGHT checklist would be a useful tool to improve the reporting quality of guidelines.

Reporting specifications regarding epilepsy practice guidelines based on the RIGHT reporting checklist: an analysis

ObjectiveClinical guidelines are designed to optimise patient care and provide efficient approaches for therapy. Epilepsy is a chronic brain disorder that continues to experience a considerable treatment gap due to...

A Comparison of AGREE and RIGHT: which Clinical Practice Guideline Reporting Checklist Should Be Followed by Guideline Developers?

A clinical practice guideline (CPG) reporting checklist is used to assist CPG developers in recording what content should be provided in a CPG report. Recently, two checklists have become available on the Enhancing the QUAlity and Transparency Of health Research Network website: AGREE (Appraisal of Guidelines, Research and Evaluation) published in 2016 and RIGHT (Reporting Items for practice Guidelines in HealThcare) published in 2017. The objective of this study was to describe the advantages and disadvantages of these two CPG reporting checklists. Two epidemiologists who lacked experience using both AGREE and RIGHT but were familiar with evidence-based medicine methodology independently compared AGREE with RIGHT on an item-by-item basis. Their assessments were compiled on a pre-designed data form and any disagreements were resolved through discussion. Three other co-authors independently compared AGREE with RIGHT and decided if they agreed with the results of comparison of the two CPG reporting checklists from the first two co-authors. Finally, another co-author reviewed the comparison results to ensure that the description was clear and understandable. The following six relationships between the two checklists were observed: (1) 11 items from AGREE completely matched with 12 items from RIGHT; (2) four items were listed in AGREE only; (3) 12 items were listed in RIGHT only; (4) three items in AGREE were partially covered by three items in RIGHT; (5) six items in RIGHT were partially covered by three items in AGREE; and (6) two items intersected across AGREE and RIGHT. Based on the comparison results, the potential impact analysis of selecting either checklist is described. We recommend that CPG developers use either AGREE plus items unique to RIGHT or RIGHT plus items unique to AGREE.

Critical appraisal of guidelines for coronary artery disease on dual antiplatelet therapy: More consensus than controversies.

BackgroundDual antiplatelet therapy (DAPT) in the form of aspirin plus a P2Y12 inhibitor, when indicated, is one of the key treatments in coronary artery disease (CAD). Many recommendations on DAPT in patients with CAD based on current guidelines are largely inconsistent. In our current study, we aimed at systematically reviewing DAPT‐relevant clinical practice guidelines, and highlighting their commonalities and differences for better informed decision‐making.MethodsContemporary guidelines in English were searched in MEDLINE, Embase and websites of guideline organizations and professional societies. Guidelines with recommendations on DAPT for CAD patients were included. Guideline quality was appraised with the 6‐domain Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The reporting of conflicts of interest (COI) was assessed individually with supplementary items from the RIGHT (Reporting Item for Practice Guidelines in Healthcare) checklist. Meanwhile, extraction of recommendations was performed.ResultsA total of 18 guidelines fulfilled our inclusion criteria. Most of them were graded with relatively good scores averaging from 42% to 74%. Domains for lower scores were in “stakeholder involvement” and “application.” The reporting of COI was satisfactory. For the recommendations on DAPT, most guidelines with high AGREE II scores included consistent recommendations on the timing and P2Y12 inhibitor selection. Nonetheless, conflicts still exist on the duration of DAPT.ConclusionsQuality of guidelines for DAPT in CAD was relatively high, though defects existed in “Applicability” and “Stakeholder Involvement.” As these guidelines developed, DAPT recommendations gradually converged on a consensus. Clinical decision should be made on an individual basis.

Analysis of completeness of reporting utilizing the Reporting Items for practice Guidelines in Healthcare Statement in gastroenterology clinical practice guidelines.

Assessing reporting quality is important as it allows distinctions to be made between poor methodology and poor reporting practices. The Reporting Items for practice Guidelines in Healthcare (RIGHT) Statement checklist was published in 2017 to improve the thoroughness and reporting quality of clinical practice guidelines (CPGs). CPGs are evidence-based recommendations developed to assist clinician decision-making in the diagnosis and management of patients. The aim of this study is to assess the completeness of reporting in CPGs listed by the American College of Gastroenterology (ACG) and their frequency of reporting items listed in the RIGHT Statement. Using the 22 criteria (35 items) of the RIGHT Statement checklist, two researchers independently documented the adherence to each item for all eligible guidelines listed by the ACG. This study was conducted from 01/10/18 to 05/12/18. Data were recorded onto a prespecified Google data abstraction form and extracted into MS Excel for statistical analysis. Out of 38 eligible guidelines, nine of the 35 RIGHT (25.7%) checklist items were met with less than 50% adherence. The mean adherence was 26.8 (SD ± 9.5); median adherence was 30 (interquartile range 21.5-33.5). The publication dates ranged from 2007 to 2017 with seven of the guidelines (18.4%) published between 2007 and 2009, 11 (29%) published between 2010 and 2013, and 20 (52.6%) published between 2014 and 2017. The completeness of reporting in CPGs listed by the ACG remains inadequate in several key areas. Poor adherence to items of the RIGHT Statement checklist demonstrates that there is area for improvement in reporting quality.

Extending the RIGHT statement for reporting adapted practice guidelines in healthcare: the RIGHT-Ad@pt Checklist protocol

IntroductionThe adaptation of guidelines is an increasingly used methodology for the efficient development of contextualised recommendations. Nevertheless, there is no specific reporting guidance. The essential Reporting Items of Practice Guidelines...

Quality assessment of clinical practice guidelines used in oral and maxillofacial surgery

An assessment of the quality of oral and maxillofacial surgery clinical practice guidelines is lacking. The aim of this investigation was to assess the quality of guidelines using the RIGHT (Reporting Items for practice Guidelines in HealThcare) checklist. The primary outcome was to assess the score (quality) of guidelines based on the RIGHT checklist and to identify predictors (region, type, single or multi-centre, and speciality/non-speciality) influencing the quality score. In this review, following a search of electronic databases and national society websites, a total of 25 guidelines were independently assessed by two assessors against the 22-item RIGHT checklist. Inter-assessor reliability was assessed. Deficiencies in the reporting of items relating to limitations, funding, declaration and management of interests, healthcare questions, and quality assurance were evident. The median overall score for the guidelines was 28 (range 14–66). Guidelines produced by multiple centres (β=57.15, 95% confidence interval −26.62 to 87.68, P= 0.001, multivariate analysis) and non-speciality societies (β=20, 95% confidence interval −0.03 to 40.03, P=0.05, univariate analysis) tended to have higher quality scores. Overall, the quality of clinical practice guidelines used in oral and maxillofacial surgery was deemed suboptimal. If clinical practice guidelines are to be used in making treatment decisions for patients, clinicians should be aware of their possible limitations.

Are paediatric clinical practice guidelines trustworthy?

To assess the methodological and reporting quality of paediatric clinical practice guidelines (CPGs) in National Guideline Clearinghouse (NGC) using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and Reporting Items for Practice Guidelines in Healthcare (RIGHT) standard. We identified all published CPGs through the NGC, and search records were screened in duplicate for inclusion. Two researchers evaluated the methodological and reporting quality of paediatric CPGs using the AGREE II instrument and RIGHT standard. STATA version 12.0 and SPSS version 22.0 software were used to analyse the related data. A total of 50 paediatric CPGs were included. The scores for all six domains by AGREE II instrument were presented as follows: scope and purpose (85.6 ± 9.59), stakeholder involvement (69.15 ± 19.32), rigour of development (73.19 ± 17.18), clarity of presentation (78.51 ± 14.36), applicability (54.61 ± 22.63) and editorial independence (68.42 ± 13.06). In the seven domains of the RIGHT standard, the reporting rate of the recommendation domain was the lowest (52.86%).The highest reporting rate was the other information domain, which was 68%.There was a high correlation between reporting the completeness of CPGs using the AGREE II instrument and RIGHT standard (r = 0.77, P < 0.001). The paediatric CPGs from NGC have good quality. There was a high correlation in the completeness of reporting for paediatric CPGs using the AGREE II instrument and RIGHT standard. It could be concluded that the CPGs of good methodological quality have good reporting quality. Maybe the researcher should effectively combine the AGREE II instrument and RIGHT standard in the development process of CPGs.

Protocol of reporting items for public versions of guidelines: the Reporting Tool for Practice Guidelines in Health Care—public versions of guidelines

IntroductionPatient and public versions of guidelines (PVGs) can help with individual decision making and enhance the patient–clinician relationship by providing easily understandable and reliable information. An increasing number of guideline...

Using the RIGHT statement to evaluate the reporting quality of clinical practice guidelines in traditional Chinese medicine

ObjectiveTo evaluate the reporting quality of clinical practice guidelines (CPGs) in traditional Chinese medicine (TCM).MethodsA systematic search was undertaken to extract CPGs for TCM. The RIGHT (Reporting Items for practice Guidelines in Healthcare) statement was used to calculate scores for the reporting quality in terms of domains and items, followed by a subgroup analysis of the results and determination of the correlation between the RIGHT and AGREE II (Appraisal of Guidelines for Research and Evaluation II) scores.ResultsOverall, 539 TCM CPGs were included. (1) The mean scores (Med, IQR) for each RIGHT domain were as follows: basic information (4, 1), background (3, 2), evidence (0, 0), recommendations (2, 2), review and quality assurance (0, 0), funding and declaration and management of interests (0, 0.5), and other information (0, 0). (2) The items with a low reporting rate (<10%) included 2, 5, 8b, 9a, 10a, 10b, 11a, 11b, 14a, 14b, 14c, 16, 17, 19b, 20, 21, and 22, and those with a high reporting rate (> 90%) included 1a, 1b, 1c, 7b, 13a, and 13b. (3) In recent years, the reporting quality of TCM CPGs has improved, and there was a significant difference among the organizations (P = 0.000), where that of the updated versions was greater than that of the historical versions (P = 0.047). (4) The RIGHT and AGREE II scores were positively correlated (P = 0.014).ConclusionsAt present, although the reporting quality of TCM CPGs is improving, the overall quality remains suboptimal. Guideline developers should strictly follow the evidence-based process of developing guidelines and should follow the RIGHT statement to produce a standardized report when writing guidelines.

Reporting quality of European and Croatian health practice guidelines according to the RIGHT reporting checklist

BackgroundHealth practice guidelines (HPGs) are important tools for the translation of evidence into practice. Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist provides guidance on reporting health practice guidelines (HPGs). We assessed the reporting completeness and quality of a set of national (Croatian) and relevant transnational (European) HPGs.MethodsThe national sample included all HPGs published in the official journal of the Croatian Medical Association in 2014–2016. We searched PubMed to identify relevant European guidelines (n = 24). Two independent reviewers assessed the adherence with the items on the RIGHT checklist. Kappa score was used to measure the level of agreement. Frequentist and Bayes statistics Bayes factor (BF10) was used to evaluate the differences between the national and transnational HPGs.ResultsOverall, Croatian and European HPGs adhered to less than 50% of RIGHT checklist items. Croatian HPGs reported a median of 14.0 (95% CI 13.0–15.0) RIGHT reporting items, and European counterparts reported a median of 16.0 (95% CI 14.0–17.2) out of the total of 35 checklist items (Mann Whitney U test, P = 0.048; BF10 = 1.543). European HPGs were better than Croatian HPGs in reporting stakeholder involvement and values and preferences (BF10 = 80.63), as well as describing the implications of costs and resources (BF10 = 55.15). Croatian HPGs better reported HPGs specified aims (BF10 = 16.90), primary intended users (BF10 = 8.70), and sources of funding (BF10 = 122.90). Most insufficiently reported items for both HPG sets were defining the guideline questions and clear outcomes, quality assurance, management of funding and conflicts of interest, and guideline limitations.ConclusionsImportant methodological details are missing from most published HPGs at national and transnational levels. To ensure better quality and adequate use of HPGs, reporting guidelines should be endorsed and used by developers and users alike.

Ein Instrument zur Erstellung von Leitlinienberichten: das RIGHT-Statement

The quality of reporting practice guidelines is often poor, and there is no widely accepted guidance or standards for such reporting in health care. The international RIGHT (Reporting Items for practice Guidelines in HealThcare) Working Group was established to address this gap. The group followed an existing framework for developing guidelines for health research reporting and the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach. A checklist and an explanation and elaboration statement were developed. The RIGHT checklist includes 22 items that are considered essential for good reporting of practice guidelines: basic information (items 1 to 4), background (items 5 to 9), evidence (items 10 to 12), recommendations (items 13 to 15), review and quality assurance (items 16 and 17), funding and declaration and management of interests (items 18 and 19), and other information (items 20 to 22). The RIGHT checklist can assist developers in reporting guidelines, support journal editors and peer reviewers when considering guideline reports, and help health care practitioners understand and implement a guideline.

A Reporting Tool for Practice Guidelines in Health Care: The RIGHT Statement.

The quality of reporting practice guidelines is often poor, and there is no widely accepted guidance or standards for such reporting in health care. The international RIGHT (Reporting Items for practice Guidelines in HealThcare) Working Group was established to address this gap. The group followed an existing framework for developing guidelines for health research reporting and the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach. It developed a checklist and an explanation and elaboration statement. The RIGHT checklist includes 22 items that are considered essential for good reporting of practice guidelines: basic information (items 1 to 4), background (items 5 to 9), evidence (items 10 to 12), recommendations (items 13 to 15), review and quality assurance (items 16 and 17), funding and declaration and management of interests (items 18 and 19), and other information (items 20 to 22). The RIGHT checklist can assist developers in reporting guidelines, support journal editors and peer reviewers when considering guideline reports, and help health care practitioners understand and implement a guideline.

Implementing Evidence-Based Recommendations for Health Care: A Roundtable Comparing European and American Experiences

A roundtable held October 5-6 1999, in Maidstone, Kent, United Kingdom, was convened to identify current strategies and ongoing challenges in implementing evidence-based practice guidelines in health care. Despite numerous new medical research findings for improving health care and despite the dissemination of many practice guidelines, the recommendations from these efforts are not being uniformly adopted. Overuse, underuse, and misuse plague the practice of medicine today. Multiple implementation strategies are more likely to succeed that a single implementation method; local selection and adaptation of guidelines are critical; and reminders, educational outreach (for prescribing), and interactive educational workshops are generally effective. In most countries, guideline development has progressed from consensus conference, to evidence-based statements, and finally to evidence-based guidelines that also consider cost-effectiveness. Guideline development is the most advanced in The Netherlands, where physicians have coordinated their efforts with the government to achieve more uniformity than is found elsewhere. Designing systems that will facilitate change--not changing physician behavior--should be the focus. The concern for effecting improvement in health care is now more acute because of the increased attention being given to medical errors and patient safety. Multifaceted approaches are clearly the most important method for improving care. Such approaches may include many improvement methods, none of which work well alone most of the time or any of the time.

Healthcare Practice Guidelines for Chronic Disease Management

New interest in healthcare practice guidelines during the last quarter of the twentieth century is marked by: (i) concern about the scientific validity of guideline recommendations, i.e. the extent to which they are reliably based on research evidence of effective practice; (ii) the intense interest of extra-professional agencies in guidelines, including the purchasers of healthcare, patient groups, governments and pharmaceutical companies, and; (iii) concern whether guidelines actually affect clinical practice.

Clinical Practice Guidelines in Health Care

Journal Article Clinical Practice Guidelines in Health Care Get access Jennifer L. Thomas Jennifer L. Thomas Government affairs, ASCP Washington Office. Search for other works by this author on: Oxford Academic PubMed Google Scholar Laboratory Medicine, Volume 25, Issue 11, 1 November 1994, Pages 701–702, https://doi.org/10.1093/labmed/25.11.701 Published: 01 November 1994