[PP.26.09] QUALITY OF CLINICAL PRACTICE GUIDELINES FOR THE MANAGEMENT OF HYPERTENSION, A SYSTEMATIC ANALYSIS USING THE AGREE II INSTRUMENT

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Abstract

Objective:

Clinical practice guidelines (CPGs) provide explicit recommendations for clinical practice in order to optimize results, minimize risks and promote cost-effective practice. The quality of many CPGs was modest and that heterogeneity was existed among different guidelines. (AGREE) instrument updated it is an instrument.

Objective:

This systematic analysis aimed to assess the CPGs for the prevention and management of hypertension by AGREE II instrument that provides criteria to assess the quality of CPGs.

Design and method:

To identify CPGs of hypertension, a systematic search of the following relevant literature databases including PubMed, EMBASE, Web of Science, the National Guideline Clearinghouse (NGC), CNKI, Wan fang Data, VIP, and CBM was performed in the period from inception to Dec. 2015 and AGREE II instrument that consisting of six domains covering 23 key items was used to assess the quality of the included guidelines.

Results:

Eventually 41 guidelines met our inclusion criteria (10 CPGs in Chinese and 31 CPGs in English). The data of overall recommendation were presented as follow: strongly recommended (15%), recommended(29%), weakly recommended (51%), not recommended(5%). The scores of mean ± sd for all domains was: “Scope and Purpose” (58.65% ± 12.67%), “Stakeholder Involvement” (48.07% ± 11.41%), “Rigour of Development” (27.31% ± 12.29%), “Clarity of Presentation” (53.89% ± 11.09%, “Applicability” (40.10% ± 13.33%), “Editorial Independence” (38.75% ± 16.43%). All differences were statistically insignificant for all domains (P > 0.05) according to publication time. CPGs using evidenced-based method had higher quality than non-evidence-based for all domains, the differences were statistically insignificant with the exception of “Stakeholder Involvement” (P = 0.14) and “Clarity of Presentation” (P = 0.61). All domain scores appeared slightly higher for CPGs developed by association and society versus those by individual. The difference results were statistically insignificant for all domains (P > 0.05).

Conclusions:

Some hypertension guidelines have flawed methodological quality. A more systematic approach in the development of these guidelines is recommended. The AGREE II instrument can be a useful tool to improve the quality of guidelines and should be served as a compulsory checklist for CPGs.

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