Limits...
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.


Domain scores for each guideline based on the Appraisal of Guidelines for Research and Evaluation II Instrument. A-C: Each Appraisal of Guidelines for Research and Evaluation II domain score for guidelines is presented on the X-axis as a percentage of 100 (0% = the domain was not at all satisfied; and 100% = fully satisfied). D: Overall scores for guidelines. WGO: World Gastroenterology Organization.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5037092&req=5

Figure 2: Domain scores for each guideline based on the Appraisal of Guidelines for Research and Evaluation II Instrument. A-C: Each Appraisal of Guidelines for Research and Evaluation II domain score for guidelines is presented on the X-axis as a percentage of 100 (0% = the domain was not at all satisfied; and 100% = fully satisfied). D: Overall scores for guidelines. WGO: World Gastroenterology Organization.

Mentions: Eleven guidelines were appraised according to AGREE II, as presented in Table 1 and Figure 2. We highly recommended the two guidelines, United States 12[1] and Europe 16[2], given the high scores and the authority of the organizations. Additionally, Italy 10[12] and South Korea 13[13] also presented comprehensive content, rigorous procedures and good applicability. Lastly, WGO 14[14] offered a variety of algorithms for clinical practice.


Clinical guidelines of non-alcoholic fatty liver disease: A systematic review
Domain scores for each guideline based on the Appraisal of Guidelines for Research and Evaluation II Instrument. A-C: Each Appraisal of Guidelines for Research and Evaluation II domain score for guidelines is presented on the X-axis as a percentage of 100 (0% = the domain was not at all satisfied; and 100% = fully satisfied). D: Overall scores for guidelines. WGO: World Gastroenterology Organization.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Domain scores for each guideline based on the Appraisal of Guidelines for Research and Evaluation II Instrument. A-C: Each Appraisal of Guidelines for Research and Evaluation II domain score for guidelines is presented on the X-axis as a percentage of 100 (0% = the domain was not at all satisfied; and 100% = fully satisfied). D: Overall scores for guidelines. WGO: World Gastroenterology Organization.
Mentions: Eleven guidelines were appraised according to AGREE II, as presented in Table 1 and Figure 2. We highly recommended the two guidelines, United States 12[1] and Europe 16[2], given the high scores and the authority of the organizations. Additionally, Italy 10[12] and South Korea 13[13] also presented comprehensive content, rigorous procedures and good applicability. Lastly, WGO 14[14] offered a variety of algorithms for clinical practice.

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.