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Actinic Keratosis Clinical Practice Guidelines: An Appraisal of Quality.

Kirby JS, Scharnitz T, Seiverling EV, Ahrns H, Ferguson S - Dermatol Res Pract (2015)

Bottom Line: High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated.However, the rigor and validity of some guidelines were weak.So, it is important for providers to be aware of the features that contribute to a high-quality, practical document.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.

ABSTRACT
Actinic keratosis (AK) is a common precancerous skin lesion and many AK management guidelines exist, but there has been limited investigation into the quality of these documents. The objective of this study was to assess the strengths and weaknesses of guidelines that address AK management. A systematic search for guidelines with recommendations for AK was performed. The Appraisal of Guidelines for Research and Evaluation (AGREE II) was used to appraise the quality of guidelines. Multiple raters independently reviewed each of the guidelines and applied the AGREE II tool and scores were calculated. Overall, 2,307 citations were identified and 7 fulfilled the study criteria. The Cancer Council of Australia/Australian Cancer Network guideline had the highest mean scores and was the only guideline to include a systematic review, include an evidence rating for recommendations, and report conflicts of interest and funding sources. High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated. Features such as concise tables, pictorial diagrams, and explicit links to evidence are helpful. However, the rigor and validity of some guidelines were weak. So, it is important for providers to be aware of the features that contribute to a high-quality, practical document.

No MeSH data available.


Related in: MedlinePlus

Literature search and study selection process.
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Literature search and study selection process.

Mentions: The search strategy identified 2,307 records and after review ultimately seven records were included in the study (Figure 1). The characteristics of the seven CPG are listed in Table 1. Of the seven CPG, one was from Australia [11], one was from Britain [12], three were from Germany [13–15], one was from Italy [16], and one was from the United States [10]. The range for interrater agreement was 0.39–0.86. Analysis showed that one appraiser had only fair agreement with other appraisers (0.39 [p = .38]). This rater was a first-year medical student and it was presumed that this reflected clinical experience rather than CPG quality so his scores were removed and subsequent calculations did not include these scores. The correlation coefficients among the three remaining appraisers, which included two dermatologists and a family practitioner, were moderate or better (0.54–0.86).


Actinic Keratosis Clinical Practice Guidelines: An Appraisal of Quality.

Kirby JS, Scharnitz T, Seiverling EV, Ahrns H, Ferguson S - Dermatol Res Pract (2015)

Literature search and study selection process.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4588356&req=5

fig1: Literature search and study selection process.
Mentions: The search strategy identified 2,307 records and after review ultimately seven records were included in the study (Figure 1). The characteristics of the seven CPG are listed in Table 1. Of the seven CPG, one was from Australia [11], one was from Britain [12], three were from Germany [13–15], one was from Italy [16], and one was from the United States [10]. The range for interrater agreement was 0.39–0.86. Analysis showed that one appraiser had only fair agreement with other appraisers (0.39 [p = .38]). This rater was a first-year medical student and it was presumed that this reflected clinical experience rather than CPG quality so his scores were removed and subsequent calculations did not include these scores. The correlation coefficients among the three remaining appraisers, which included two dermatologists and a family practitioner, were moderate or better (0.54–0.86).

Bottom Line: High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated.However, the rigor and validity of some guidelines were weak.So, it is important for providers to be aware of the features that contribute to a high-quality, practical document.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.

ABSTRACT
Actinic keratosis (AK) is a common precancerous skin lesion and many AK management guidelines exist, but there has been limited investigation into the quality of these documents. The objective of this study was to assess the strengths and weaknesses of guidelines that address AK management. A systematic search for guidelines with recommendations for AK was performed. The Appraisal of Guidelines for Research and Evaluation (AGREE II) was used to appraise the quality of guidelines. Multiple raters independently reviewed each of the guidelines and applied the AGREE II tool and scores were calculated. Overall, 2,307 citations were identified and 7 fulfilled the study criteria. The Cancer Council of Australia/Australian Cancer Network guideline had the highest mean scores and was the only guideline to include a systematic review, include an evidence rating for recommendations, and report conflicts of interest and funding sources. High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated. Features such as concise tables, pictorial diagrams, and explicit links to evidence are helpful. However, the rigor and validity of some guidelines were weak. So, it is important for providers to be aware of the features that contribute to a high-quality, practical document.

No MeSH data available.


Related in: MedlinePlus