Clinical practice guidelines on newborn hearing screening: A systematic quality appraisal using the AGREE II
Kevin Chorath1, Luis Garza2, Aina Tarriela2
1Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.
Insights
Most guidelines for newborn hearing loss detection and management are of average or low quality. This review highlights variability and aims to improve future guideline development and clinical selection.
Area of Science:
- Audiology
- Public Health
- Evidence-Based Medicine
Background:
- Numerous guidelines exist for newborn hearing loss screening and management.
- The methodological quality of these protocols has not been previously assessed.
Purpose of the Study:
- To identify and critically evaluate existing guidelines and consensus statements for neonatal hearing loss detection and management.
Main Methods:
- A comprehensive literature search was conducted across major databases and grey literature.
- The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used by four independent reviewers.
- Intraclass correlation coefficients (ICC) assessed inter-rater agreement.
Main Results:
- Twelve guidelines were evaluated; only two were deemed 'high quality'.
- The 'Scope and Purpose' domain scored highest (91.3%), while 'Rigor of Development' scored lowest (35.8%).
- Good to very good inter-rater agreement was observed across all AGREE II domains (ICC 0.63-0.95).
Conclusions:
- Significant variability exists in the methodological quality of guidelines for neonatal hearing loss.
- Findings can inform improved reporting of future guidelines and aid clinical selection of existing ones.
Introduction:
Several guidelines and consensus statements have been produced and disseminated for the detection and management of newborn hearing loss. However, to date, the quality and methodologic rigor of these screening and management protocols have not been appraised.
Objective:
To identify and evaluate existing guidelines and consensus statements for the detection and management of neonatal hearing loss.
Methods:
A comprehensive search of EMBASE, MEDLINE/PubMed, SCOPUS and grey literature sources was conducted until August 2020. The quality of these guidelines was assessed by four independent reviewers using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II). Domain scores were considered satisfactory quality if they scored >60%, and intraclass correlation coefficients (ICC) were calculated to assess agreement among the appraisers.
Results:
Twelve guidelines were assessed for critical evaluation. Only two guidelines were classified as 'high quality', and the remaining were 'average' or 'low quality'. The 'Scope and Purpose' domain achieved the highest mean score (91.3% ± 5.8%), and lowest was 'Rigor of Development' (35.8% ± 19.1%). ICC analysis showed good to very good agreement across all domains (0.63-0.95).
Conclusion:
These findings highlight the variability in methodologic quality of guidelines and consensus statement for the detection and management of neonatal hearing loss. These results may help to improve the reporting of future guidelines and guide the selection and use of these guidelines in clinical practice.
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