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Clinical guidelines of non-alcoholic fatty liver disease: A systematic review

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To perform a systematic review to grade guidelines and present recommendations for clinical management of non-alcoholic fatty liver disease (NAFLD).

Methods: A database search was conducted on PubMed for guidelines published before May 2016, supplemented by reviewing relevant websites. The Appraisal of Guidelines for Research and Evaluation (ARGEE) Instrument II was a tool designed to appraise the methodological rigor and transparency in which a clinical guideline is developed and it is used internationally. It was used to appraise the quality of guidelines in this study. The inclusion criteria include: clinical NAFLD guidelines for adults, published in English, and released by governmental agencies or key organizations.

Results: Eleven guidelines were included in this study. Since 2007, guidelines have been released in Asia (3 in China, 1 in South Korea, and 1 in Japan), Europe (1 in Italy), America (1 in United States and 1 in Chile) and three international agencies [European associations joint, Asia-Pacific Working Party and World Gastroenterology Organization (WGO)]. Using the ARGEE II instrument, we found US 2012 and Europe 2016 had the highest scores, especially in the areas of rigor of development and applicability. Additionally, Italy 2010 and Korea 2013 also presented comprehensive content, rigorous procedures and good applicability. And WGO 2014 offered various algorithms for clinical practice. Lastly, a practical algorithm for the clinical management was developed, based on the recommended guidelines.

Conclusion: This is the first systematic review of NAFLD guidelines. It may yield insights for physicians and policy-makers in the development and application of guidelines.

No MeSH data available.


Flow chart of guidelines searching.
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Figure 1: Flow chart of guidelines searching.

Mentions: As shown in Figure 1, eleven guidelines met the criteria and were included in the final version of this systematic review. Since 2007, five guidelines were released in Asia (3 in China, 1 in Japan and 1 in South Korea), while three guidelines were released in the United States, Italy and Chile, respectively (Table 1). Three guidelines were released by international agencies, i.e. Asia-Pacific Working Party, World Gastroenterology Organization (WGO) and a joint commission of European associations.


Clinical guidelines of non-alcoholic fatty liver disease: A systematic review
Flow chart of guidelines searching.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037092&req=5

Figure 1: Flow chart of guidelines searching.
Mentions: As shown in Figure 1, eleven guidelines met the criteria and were included in the final version of this systematic review. Since 2007, five guidelines were released in Asia (3 in China, 1 in Japan and 1 in South Korea), while three guidelines were released in the United States, Italy and Chile, respectively (Table 1). Three guidelines were released by international agencies, i.e. Asia-Pacific Working Party, World Gastroenterology Organization (WGO) and a joint commission of European associations.

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To perform a systematic review to grade guidelines and present recommendations for clinical management of non-alcoholic fatty liver disease (NAFLD).

Methods: A database search was conducted on PubMed for guidelines published before May 2016, supplemented by reviewing relevant websites. The Appraisal of Guidelines for Research and Evaluation (ARGEE) Instrument II was a tool designed to appraise the methodological rigor and transparency in which a clinical guideline is developed and it is used internationally. It was used to appraise the quality of guidelines in this study. The inclusion criteria include: clinical NAFLD guidelines for adults, published in English, and released by governmental agencies or key organizations.

Results: Eleven guidelines were included in this study. Since 2007, guidelines have been released in Asia (3 in China, 1 in South Korea, and 1 in Japan), Europe (1 in Italy), America (1 in United States and 1 in Chile) and three international agencies [European associations joint, Asia-Pacific Working Party and World Gastroenterology Organization (WGO)]. Using the ARGEE II instrument, we found US 2012 and Europe 2016 had the highest scores, especially in the areas of rigor of development and applicability. Additionally, Italy 2010 and Korea 2013 also presented comprehensive content, rigorous procedures and good applicability. And WGO 2014 offered various algorithms for clinical practice. Lastly, a practical algorithm for the clinical management was developed, based on the recommended guidelines.

Conclusion: This is the first systematic review of NAFLD guidelines. It may yield insights for physicians and policy-makers in the development and application of guidelines.

No MeSH data available.