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Global emergency care clinical practice guidelines: A landscape analysis
Michael McCaul1, Mike Clarke1,2, Stevan R Bruijns3
1Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, South Africa.
Summary
High-quality clinical practice guidelines (CPGs) for prehospital care are scarce in low-resource settings. Adaptive guideline development is crucial for emergency care in these regions.
Area of Science:
- Emergency Medicine
- Health Systems Research
Background:
- Adaptive guideline development relies on existing high-quality clinical practice guidelines (CPGs).
- Assessing the characteristics and quality of global CPGs for prehospital care is essential for strengthening guideline development in low-resource emergency care settings.
Purpose of the Study:
- To describe the characteristics and quality of worldwide CPGs relevant to prehospital care.
- To inform guideline development strategies for low-resource settings.
Main Methods:
- A descriptive study of international CPGs relevant to emergency care was conducted.
- The African Federation for Emergency Medicine (AFEM) CPG project database from 2016 was utilized.
- Guideline quality was assessed using the AGREE II tool, independently and in duplicate.
Main Results:
- 276 guidelines were included; less than 2% originated from low- and middle-income countries (LMICs).
- Only 15% of guidelines were prehospital-specific, with none directly applicable to prehospital care in LMICs.
- National bodies produced higher quality guidelines compared to international bodies, professional societies, or clinician/academic groups.
Conclusions:
- Existing high-quality CPGs for emergency care do not adequately address prehospital needs in LMICs, particularly in Africa.
- Strengthening guideline development capacity, including adaptive methods, is a priority for improving emergency care in resource-constrained settings.
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