Validity of the Good Practice Guidelines: The example of type 2 diabetes
Benoit V Tudrej1, Delphine Favard2, Hélène Vaillant-Roussel3
1Universite de Poitiers UFR Medecine et Pharmacie, General Practice Department, 6 rue de la miletrie, Poitiers, Nouvelle Aquitaine FR 86073, France; Société Française et Francophone d'Ethique Médicale, SFFEM, 45 Rue des Saints-Pères, Paris FR 75006, France; Universite Claude Bernard Lyon 1, University College of General Medicine, 8 Avenue Rockefeller, 69008 Lyon, France.
Aims:
To assess the methodological quality of the systematic reviews of the literature for Good Practice Guidelines (GPGs) for treatment of type 2 diabetes (T2D).
Methods:
The GPGs on treatment of T2D from May 2012 onwards were searched on PubMed, the Guidelines International Network, the National Guidelines Clearing House and the Infobanque des guides de pratique clinique. Quality of the GPGs was assessed by means of grading of levels of evidence, strength of recommendations, statements pertaining to systematic reviews, description of their methods, search for Randomized Controlled Trials meta-analyses, and citations from three meta-analyses which contested the strategy of intensive glycemic control and metformin as first-line treatment.
Results:
Fiflty-two GPGs were included; half of them had and applied a system of grading and strength of recommendation and 58% stated they had carried out a systematic review. Only one GPG cited the three meta-analyses. Three quarters of the GPGs failed to detail their bibliographic research methods.
Conclusion:
The GPGs for treatment of T2D were of poor quality and their methodological rigor was insufficient. Even though the meta-analyses had a higher level of evidence, they were seldom cited.
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