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Methodological quality and recommendations of hemophilia clinical practice guidelines: A scoping review

Carolina J Delgado-Flores1, David García-Gomero2, Liseth Pinedo-Castillo3,4

  • 1Carrera de Farmacia y Bioquímica, Facultad de Ciencias de la Salud Universidad Científica del Sur Lima Perú.

Health Science Reports
|July 17, 2023
PubMed

Insights

Quality of hemophilia clinical practice guidelines (CPGs) varies, with inconsistent prophylaxis recommendations. Further development is needed for transparent, evidence-based decision-making in hemophilia care.

Area of Science:

  • Hematology
  • Clinical Practice Guidelines
  • Evidence-Based Medicine

Background:

  • Clinical practice guidelines (CPGs) are crucial for healthcare professionals managing hemophilia.
  • Variations in CPG quality and recommendations necessitate rigorous assessment.
  • This study focuses on hemophilia CPGs published between 2017 and 2021.

Purpose of the Study:

  • To evaluate the methodological quality of hemophilia CPGs.
  • To compare prophylaxis recommendations within these guidelines.
  • To identify areas for improvement in CPG development for hemophilia.

Main Methods:

  • Comprehensive literature search across multiple databases (PubMed, TripDatabase, etc.).
  • Methodological quality assessment using the AGREE-II instrument.
  • Comparative analysis of prophylaxis recommendations, including dose and initiation.

Main Results:

  • Eleven hemophilia CPGs met inclusion criteria; 5 from upper-middle-income countries.
  • Prophylaxis dose recommendations were inconsistent (low, intermediate, or high dose).
  • Few CPGs provided justification for recommendations; no economic evaluations were performed.

Conclusions:

  • Hemophilia CPGs exhibit suboptimal quality and inconsistent prophylaxis recommendations.
  • Lack of justification and transparency hinders evidence-based decision-making.
  • Improvements in CPG development are essential for reliable hemophilia care.
Abstract

Keywords:
clinical guidelinesclinical practice guidelineshemophiliaprophylaxis dose

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