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Critical Appraisal of Guidelines for Daytime Urinary Incontinence in Children: Evaluation of Quality and
J Marleen Linde1,2, Ilse Hofmeester3, Martijn G Steffens2
1Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Insights
This study evaluated guidelines for childhood non-neurogenic daytime urinary incontinence (DUI). Only two of eight guidelines met quality standards, highlighting the need for improved development using tools like AGREE II.
Area of Science:
- Pediatric Urology
- Clinical Guideline Evaluation
- Evidence-Based Medicine
Background:
- Non-neurogenic daytime urinary incontinence (DUI) in children is a common condition.
- Existing clinical practice guidelines for managing childhood DUI vary in quality.
- A systematic assessment of these guidelines is needed to inform clinical practice.
Purpose of the Study:
- To evaluate the quality of current guidelines for non-neurogenic daytime urinary incontinence (DUI) in children.
- To compare the content of these guidelines regarding the assessment of children with DUI.
- To provide recommendations for improving guideline development and selection.
Main Methods:
- Systematic literature search for guidelines on childhood non-neurogenic DUI.
- Quality assessment using the Appraisal of Guidelines for Research and Evaluation II (AGREE) instrument.
- Descriptive comparison of diagnostic recommendations across included guidelines.
Main Results:
- Eight guidelines were included, with overall quality scores ranging from 2.6 to 5.8 (out of 7).
- Three guidelines were rated good, four moderate, and one low quality.
- Clarity and Presentation scored highly, while Rigour of Development and Applicability scored lowest; diagnostic recommendations showed minor variations.
Conclusions:
- The quality of guidelines for childhood non-neurogenic DUI is variable.
- Only two of eight guidelines were recommended for use without adjustments.
- Guideline developers should utilize tools like AGREE II to enhance quality; clinicians should consider guideline quality in practice.
Aims:
This study aimed to evaluate the quality of currently available guidelines on non-neurogenic daytime urinary incontinence (DUI) in children and compare their content regarding the assessment of a child with DUI.
Methods:
We conducted a systematic search for guidelines on non-neurogenic DUI in children. A multidisciplinary team assessed the quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE) instrument, which contains 23 items organized into six domains. Besides, each member evaluated if they would recommend using the guidelines. We extracted diagnostic recommendations from all guidelines for a descriptive comparison.
Results:
Eight guidelines were included. Overall quality scores ranged from 2.6 to 5.8 on a 7-point scale, (1 for lowest and 7 for highest quality). Three guidelines were rated as good, four as moderate, and one as low quality. The AGREE-II domain Clarity and Presentation received high scores across all guidelines, while Rigour of Development and Applicability received the lowest scores. Recommendations for diagnostics were generally similar, with variations observed in guidelines targeting primary and secondary healthcare.
Conclusions:
This study is the first to assess the quality of guidelines on non-neurogenic DUI in children. The quality varies, only two out of eight guidelines were recommended by the review team without adjustments. Guideline developers could improve the quality of their guidelines by using tools like AGREE II. Clinicians should consider the findings of our study when selecting a guideline to use in their daily practice.
Clinical Trial Registration:
As this is a review, no clinical trial registration was conducted. The review protocol has been registered in PROSPERO (CRD42021149059).
