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Abdominal aortic aneurysm clinical practice guidelines: a methodological assessment using the AGREE II instrument
Kia Hau Matthew Tan1, Safa Salim1, Matthew Machin1
1Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
BMJ Open
|January 21, 2022
Summary
This study assessed abdominal aortic aneurysm (AAA) clinical practice guidelines (CPGs). Four guidelines met quality standards, but all require methodological improvements for better patient care.
Area of Science:
- Cardiovascular Medicine
- Health Services Research
Background:
- Clinical practice guidelines (CPGs) offer evidence-based recommendations for managing abdominal aortic aneurysm (AAA).
- Methodological variations in CPG development necessitate quality assessment.
Purpose of the Study:
- To evaluate the methodological quality of existing abdominal aortic aneurysm (AAA) clinical practice guidelines (CPGs).
- To identify AAA CPGs suitable for clinical practice based on rigorous assessment.
Main Methods:
- A systematic search of Medline, EMBASE, and CPG databases was conducted up to October 2021.
- Five reviewers assessed seven eligible AAA CPGs using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.
- A score of ≥80% was the threshold for recommending CPGs for clinical use.
Main Results:
- Seven AAA CPGs were evaluated, demonstrating good inter-reviewer reliability.
- While CPGs generally scored above 50% in all domains, significant methodological heterogeneity was observed.
- Four CPGs achieved ≥80%, indicating adequate quality for clinical application.
Conclusions:
- Four AAA CPGs are recommended for clinical practice, though areas for improvement exist.
- Enhancements may include economic analysis and practical trial of recommendations.
- Utilizing validated tools for CPG creation and future recommendation accuracy assessment is advised.
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