Over half of clinical practice guidelines use non-systematic methods to inform recommendations: A methods study

Area of Science:

• Clinical practice guidelines
• Evidence-based medicine
• Systematic reviews

Background:

• Clinical practice guidelines are essential for clinicians managing vast medical literature.
• Guidelines are increasingly relied upon to avoid malpractice.
• Assessing evidence synthesis methods determines recommendation trustworthiness.

Purpose of the Study:

• To assess systematic evidence synthesis in guidelines.
• To determine the type of review cited for recommendations.

Main Methods:

• Retrieved 50 guidelines from TRIP and Epistemonikos (2017-2018).
• Assessed evidence synthesis processes (systematic vs. non-systematic).
• Identified review types and critical appraisal methods used.

Main Results:

• Only 17% (34%) of guidelines used systematic evidence synthesis.
• Of guidelines citing reviews, 21% assessed review risk of bias.
• Primary study quality was reported in 60% of guidelines.

Conclusions:

• Systematic reviews provide high-quality evidence for guidelines.
• Non-systematic methods compromise evidence validity and trustworthiness.
• Ensuring systematic synthesis is crucial for reliable clinical recommendations.