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Assessing the quality of dental clinical practice guidelines
Suhaym Mubeen1, Kunal Patel2, Ziba Cunningham3
1Department of Orthodontics, King's College London Dental Institute, Floor 22, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, SE1 9RT, United Kingdom.
Objectives:
The primary aim of this study was to evaluate the quality of published dental clinical guidelines using the AGREE II instrument.
Methods:
Online searching of a wide range of organisations (national and International) was undertaken to identify dental clinical practice guidelines published between 2000 and 2014. The quality of each included guideline was assessed in relation to the AGREE II instrument by four assessors independently. Inter-rater agreement was assessed. Descriptive statistics and both univariate and multivariate analyses were conducted.
Results:
162 guidelines were identified. The overall mean quality score was 51.9% (SD 13.3). There was variation in the reporting quality of individual domains with both Applicability (20.4%) and Editorial Independence (34.25%) poorly reported. Variation between the overall quality scores for guidelines produced by different dental specialities was evident. The quality of guidelines improved per publication year (β=0.76, 95% CI: 0.26, 1.26, p=0.003). Guidelines based on formal evidence (β=19.94, 95% CI: 15.25, 24.64, p=0.001) achieved higher quality scores.
Conclusion:
Overall, the quality of clinical dental practice guidelines is suboptimal. There is variation in the overall quality, reporting of individual items and domains of the AGREE II instrument between different dental speciality clinical practice guidelines. Guidelines based on formal evidence achieved higher quality scores.
Clinical Significance:
Clinicians should be aware of the variation in the quality of dental clinical guidelines in particular related to methodological rigour. The use of formal evidence may be a useful indicator of their quality prior to their implementation.