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Quality of pediatric clinical practice guidelines
Yali Liu1, Yuan Zhang2,3, Shu Wang4
1Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China. lyl_201006@126.com.
Insights
Recent pediatric clinical practice guidelines (CPGs) show improved quality but still require enhancement. Key areas like applicability and development rigor need attention to ensure high-quality pediatric healthcare recommendations.
Area of Science:
- Pediatric Medicine
- Healthcare Quality Improvement
- Clinical Practice Guidelines
Background:
- A comprehensive evaluation of recent pediatric clinical practice guidelines (CPGs) is lacking.
- Assessing the quality of pediatric CPGs and identifying factors influencing their quality is crucial.
- The study aims to foster more consistent development and application of CPGs.
Purpose of the Study:
- To evaluate the quality of pediatric clinical practice guidelines (CPGs) published between 2017 and 2019.
- To identify factors that impact the quality of these pediatric CPGs.
- To promote improved development and application of CPGs in pediatric care.
Main Methods:
- Searched PubMed, MedLive, and other key databases for pediatric CPGs from 2017-2019.
- Utilized the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument for quality assessment.
- Employed linear regression analysis to determine factors influencing CPG quality.
Main Results:
- 216 pediatric CPGs were assessed, achieving a mean AGREE II score of 60.86%.
- Only 6.48% of CPGs met the "recommend" level; many required modification or were inadequate.
- Lower quality was associated with guidelines from developing regions, lack of organizational responsibility, and non-evidence-based methods.
Conclusions:
- The overall quality of pediatric CPGs has improved but requires further enhancement.
- Specific attention to "applicability" and "rigor of development" domains is necessary.
- Implementing quality control before CPG application is essential for ensuring quality and usability.
Background:
There is a lack of a comprehensive evaluation for pediatric clinical practice guidelines (CPGs) published in recent years. Here, we assessed the quality of pediatric CPGs, considering factors that might affect their quality. The aim of the study is to promote a more coherent development and application of CPGs.
Methods:
Pediatric CPGs published in PubMed, MedLive, Guidelines International Network, National Institute for Health and Care Excellence, and World Health Organization between 2017 and 2019 were searched and collected. Paired researchers conducted screening, data extraction, and quality assessment using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Linear regression analysis determined the factors affecting CPGs' quality.
Results:
The study included a total of 216 CPGs, which achieved a mean score of 4.26 out of 7 points (60.86%) in the AGREE II assessment. Only 6.48% of the CPGs reached the "recommend" level. The remaining 69.91% should have been modified before recommendation, while the other 23.61% did not reach the recommended level at all. The overall quality of recent pediatric CPGs was higher than previously, and the proportion of CPGs with low-quality decreased over time. However, there were still too few CPGs that reached a high-quality level. The "applicability" and "rigor of development" domains had generally low scores. CPGs formulated by developing countries or regions, those that are not under an organizations or groups responsibility, and those that used non-evidence-based methods were found to be associated with poorer quality in different domains as independent or combinational factors.
Conclusions:
The quality of pediatric CPGs still needs to be improved. Specifically, a quality control before applying new CPGs should be essential to ensure their quality and applicability.
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