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Quality assessment of clinical practice guidelines on the treatment of hepatocellular carcinoma or metastatic liver cancer.

Wang Y, Luo Q, Li Y, Wang H, Deng S, Wei S, Li X - PLoS ONE (2014)

Bottom Line: The mean percentage of the domain scores were: scope and purpose 83% (95% confidence interval (CI), 81% to 86%), clarity of presentation 79% (95% CI, 73% to 86%), stakeholder involvement 39% (95% CI, 30% to 49%), editorial independence 58% (95% CI, 52% to 64%), rigor of development 39% (95% CI, 31% to 46%), and applicability 16% (95% CI, 10% to 23%).Evidence-based guidelines were superior to those established by consensus for the domains of rigor of development (p<0.001), clarity of presentation (p = 0.01) and applicability (p = 0.021).The evidence-based guidelines has become mainstream for high quality CPGs development; however, there is still need to further increase the transparency and quality of evidence rating, as well as the recommendation process, and to address potential conflict of interest.

View Article: PubMed Central - PubMed

Affiliation: The Chinese Evidence-based Medicine center/The Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China; Department of Medical Administration, 363 Hospital, Chengdu, China.

ABSTRACT

Objectives: To assess the quality of the currently available clinical practice guidelines (CPGs) for hepatocellular carcinoma, and provide a reference for clinicians in selecting the best available clinical protocols.

Methods: The databases of PubMed, MEDLINE, Web of Science, Chinese Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and relevant CPGs websites were systematically searched through March 2014. CPGs quality was appraised using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument, and data analysis was performed using SPSS 13.0 software.

Results: A total of 20 evidence-based and 20 expert consensus-based guidelines were included. The mean percentage of the domain scores were: scope and purpose 83% (95% confidence interval (CI), 81% to 86%), clarity of presentation 79% (95% CI, 73% to 86%), stakeholder involvement 39% (95% CI, 30% to 49%), editorial independence 58% (95% CI, 52% to 64%), rigor of development 39% (95% CI, 31% to 46%), and applicability 16% (95% CI, 10% to 23%). Evidence-based guidelines were superior to those established by consensus for the domains of rigor of development (p<0.001), clarity of presentation (p = 0.01) and applicability (p = 0.021).

Conclusions: The overall methodological quality of CPGs for hepatocellular carcinoma and metastatic liver cancer is moderate, with poor applicability and potential conflict of interest issues. The evidence-based guidelines has become mainstream for high quality CPGs development; however, there is still need to further increase the transparency and quality of evidence rating, as well as the recommendation process, and to address potential conflict of interest.

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PRISMA flowchart of searching and selecting guidelines.
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pone-0103939-g001: PRISMA flowchart of searching and selecting guidelines.

Mentions: A total of 1,686 records were obtained after systematically searching the database and relevant websites. After an initial screening, 99 records of potential interest were identified. Of these, 59 were removed after viewing the full texts for the following reasons: a) Twelve were guidelines for non-HCC or only for diagnosis of HCC; b) Twelve were primary studies or systematic reviews; c) Ten were guidelines written in French, Korean, Spanish, etc; d) Eight were guideline summaries or letters; e) Seven were quality improvement guidelines or position statements; and f) Five were NICE IPGs or overviews. Finally, 40 guidelines published between 1999 and 2013 were included, of which 20 were evidence-based [13]–[32] and 20 were consensus-based [33]–[52] (see Figure 1 and 2 for details).


Quality assessment of clinical practice guidelines on the treatment of hepatocellular carcinoma or metastatic liver cancer.

Wang Y, Luo Q, Li Y, Wang H, Deng S, Wei S, Li X - PLoS ONE (2014)

PRISMA flowchart of searching and selecting guidelines.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126673&req=5

pone-0103939-g001: PRISMA flowchart of searching and selecting guidelines.
Mentions: A total of 1,686 records were obtained after systematically searching the database and relevant websites. After an initial screening, 99 records of potential interest were identified. Of these, 59 were removed after viewing the full texts for the following reasons: a) Twelve were guidelines for non-HCC or only for diagnosis of HCC; b) Twelve were primary studies or systematic reviews; c) Ten were guidelines written in French, Korean, Spanish, etc; d) Eight were guideline summaries or letters; e) Seven were quality improvement guidelines or position statements; and f) Five were NICE IPGs or overviews. Finally, 40 guidelines published between 1999 and 2013 were included, of which 20 were evidence-based [13]–[32] and 20 were consensus-based [33]–[52] (see Figure 1 and 2 for details).

Bottom Line: The mean percentage of the domain scores were: scope and purpose 83% (95% confidence interval (CI), 81% to 86%), clarity of presentation 79% (95% CI, 73% to 86%), stakeholder involvement 39% (95% CI, 30% to 49%), editorial independence 58% (95% CI, 52% to 64%), rigor of development 39% (95% CI, 31% to 46%), and applicability 16% (95% CI, 10% to 23%).Evidence-based guidelines were superior to those established by consensus for the domains of rigor of development (p<0.001), clarity of presentation (p = 0.01) and applicability (p = 0.021).The evidence-based guidelines has become mainstream for high quality CPGs development; however, there is still need to further increase the transparency and quality of evidence rating, as well as the recommendation process, and to address potential conflict of interest.

View Article: PubMed Central - PubMed

Affiliation: The Chinese Evidence-based Medicine center/The Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China; Department of Medical Administration, 363 Hospital, Chengdu, China.

ABSTRACT

Objectives: To assess the quality of the currently available clinical practice guidelines (CPGs) for hepatocellular carcinoma, and provide a reference for clinicians in selecting the best available clinical protocols.

Methods: The databases of PubMed, MEDLINE, Web of Science, Chinese Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and relevant CPGs websites were systematically searched through March 2014. CPGs quality was appraised using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument, and data analysis was performed using SPSS 13.0 software.

Results: A total of 20 evidence-based and 20 expert consensus-based guidelines were included. The mean percentage of the domain scores were: scope and purpose 83% (95% confidence interval (CI), 81% to 86%), clarity of presentation 79% (95% CI, 73% to 86%), stakeholder involvement 39% (95% CI, 30% to 49%), editorial independence 58% (95% CI, 52% to 64%), rigor of development 39% (95% CI, 31% to 46%), and applicability 16% (95% CI, 10% to 23%). Evidence-based guidelines were superior to those established by consensus for the domains of rigor of development (p<0.001), clarity of presentation (p = 0.01) and applicability (p = 0.021).

Conclusions: The overall methodological quality of CPGs for hepatocellular carcinoma and metastatic liver cancer is moderate, with poor applicability and potential conflict of interest issues. The evidence-based guidelines has become mainstream for high quality CPGs development; however, there is still need to further increase the transparency and quality of evidence rating, as well as the recommendation process, and to address potential conflict of interest.

Show MeSH
Related in: MedlinePlus