Transparency and Methodological Quality of Clinical Practice Guidelines in Palliative Care. Scoping Review

Area of Science:

• Medical Ethics
• Health Services Research
• Clinical Guidelines

Background:

• Palliative care (PC) and end-of-life care (EOLC) are crucial for improving patient quality of life.
• Clinical practice guidelines (CPGs) standardize care but require quality and transparency evaluation.
• Systematic assessment of PC and EOLC CPGs is limited.

Purpose of the Study:

• To assess the methodological quality and transparency of PC and EOLC CPGs for adults.
• To evaluate the completeness of reporting using the RIGHT checklist.
• To identify areas for improvement in CPG development and reporting.

Main Methods:

• A scoping review identified relevant CPGs from major databases and repositories.
• Two independent reviewers assessed CPGs using the AGREE-II tool and RIGHT checklist.
• Descriptive analyses and inter-rater agreement were calculated to ensure reliability.

Main Results:

• 23 CPGs were included; 52.2% focused on PC and were government-developed.
• AGREE-II assessment showed 60.9% 'Recommended' and 30.4% 'Recommended with modifications'.
• Applicability scored lowest (25%), while Scope and Purpose (89%) and Clarity of Presentation (83%) scored highest.

Conclusions:

• CPGs in PC and EOLC show notable gaps in applicability and transparency.
• Enhancements are required in addressing real-world implementation.
• Clearer reporting on methodology, funding, and conflicts of interest is necessary.