Platelet transfusion guidelines for thrombocytopenic patients in non-surgical and non-traumatic care settings: A systematic review and methodological quality assessment

This systematic review aimed to identify clinical practice guidelines (CPGs) for platelet transfusion in non-surgical and non-traumatic care settings, and appraise their methodological quality. We searched three databases and eight grey literature sources for CPGs published between 2015 and 2025. Methodological characteristics of the literature review and guideline development process were charted. Data on the targeted population, transfusion indication, and the direction and strength of the recommendations were extracted. CPG methodological quality was assessed using the AGREE II Rigour of Development domain. We identified 30 CPGs, including 89 recommendations. Platelet transfusion recommendations were summarized in interactive evidence maps. These tools can aid clinicians seeking evidence-based guidance to support clinical decision making, and highlight priorities for future research. AGREE II assessment indicated good to poor methodological quality of the included CPGs. This work underscores the importance of applying a rigorous and transparent methodology to ensure the development of reliable CPGs.