Related Experiment Video
Updated: Jan 23, 2026
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
A novel method of rapid appraisal of clinical practice guidelines for children with enuresis
M Trajanovska1, S King2, S Goldfeld3
1Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia 3052.
Insights
Pediatric enuresis (bedwetting) guidelines often lack methodological quality. The National Clinical Guideline Centre
Area of Science:
- Pediatric Nephrology
- Clinical Guideline Development
- Evidence-Based Medicine
Background:
- Enuresis (bedwetting) is a common pediatric condition with variable management.
- Numerous guidelines exist, but their methodological quality is unassessed.
- This study addresses the need for quality appraisal of enuresis management guidelines.
Purpose of the Study:
- To evaluate the methodological quality of current pediatric enuresis guidelines.
- To identify high-quality guidelines for clinical implementation.
Main Methods:
- A comprehensive gray literature search identified enuresis guideline documents.
- Basic appraisal used the International Centre for Allied Health Evidence (iCAHE) Checklist.
- High-scoring documents underwent detailed appraisal using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.
Main Results:
- Eighteen documents were shortlisted; iCAHE revealed poor reporting of evidence and dates.
- Only three guidelines met basic quality criteria for AGREE II appraisal.
- While recommendations were clear, stakeholder involvement information was lacking.
Conclusions:
- Many pediatric enuresis guidelines lack adequate methodological rigor.
- The National Clinical Guideline Centre's guideline demonstrated the highest quality.
- This guideline is recommended for adaptation and implementation.
Background:
Enuresis (bedwetting) is a common but variably managed pediatric condition. Despite an abundance of published documents which provide recommendations for clinical evaluation and management of enuresis, no formal appraisal of their methodological quality has been undertaken.
Objective:
The objective of the study is to evaluate the quality of current pediatric guidelines for enuresis (bedwetting) using a novel method of appraisal.
Study Design:
A comprehensive gray literature search was undertaken to identify guideline documents that provided recommendations for management of enuresis in children and adolescents. The search strategy included guideline databases, targeted websites, Google search engines, and MEDLINE. Guideline documents included clinical practice guidelines, consensus documents, position statements, and other clinical review documents. Each document underwent basic appraisal by two independent assessors using the International Centre for Allied Health Evidence (iCAHE) Guideline Quality Checklist. Those documents which (1) had an iCAHE quality score of ≥10; (2) used a systematic search strategy; and (3) linked evidence to their recommendations underwent further detailed appraisal using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.
Results:
Eighteen documents were shortlisted for basic appraisal. The iCAHE highlighted a lack of information regarding underlying evidence and dates (mean score 36% and 41%, respectively). Only three documents met basic quality criteria and progressed to detailed appraisal using the AGREE II. These included guidelines produced by the Paediatric Society of New Zealand and National Clinical Guideline Centre and a position statement from the Canadian Paediatric Society. All three guidelines presented clear and unambiguous recommendations (mean score 80%). However, information regarding stakeholder involvement was lacking (mean score 50%).
Conclusions:
Several guidelines exist for the evaluation and management of children with enuresis, but many lack appropriate methodological quality standards. The guideline produced by the National Clinical Guideline Centre achieved the highest quality rating and is recommended for future adaptation and implementation in relevant clinical settings.
Related Concept Videos
02:57The Sense of Self: Reflected Self-Appraisal and Social Comparison
01:20Lazarus's Cognitive Appraisal Theory
Primary Appraisal:...
01:26Guidelines for Nursing Documentation II
Timely documentation is crucial to ensure continuity of care for patients. Any delays in recording or reporting medical information can result in medical errors and even adverse patient outcomes. From medication administration to diagnostic test results, every detail must be accurately and promptly documented to provide the best possible care for patients.
01:06Legal Guidelines for Documentation
01:23Guidelines for Sketching a Curve
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...