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The quality of rehabilitation Clinical Practice Guidelines: An overview study of AGREE II appraisals
Archives of Physical Medicine and Rehabilitation ( IF 4.3 ) Pub Date : 2020-09-01 , DOI: 10.1016/j.apmr.2020.03.022
Marcel P Dijkers 1 , Irene Ward 2 , Thiru Annaswamy 3 , Devin Dedrick 4 , Jennie Feldpausch 5 , Andrew Moul 5 , Lilian Hoffecker 6
Affiliation  

OBJECTIVE To evaluate the quality of rehabilitation Clinical Practice Guidelines (CPGs), specifically with respect to their applicability. DATA SOURCES Medline, Embase, Web of Science, CINAHL, PsycINFO, the Cochrane Library Databases were searched for papers published in 2017-2019 that had applied the Appraisal of Guidelines for Research & Evaluation II (AGREE II) CPG quality assessment tool to rehabilitation CPGs. STUDY SELECTION 449 de-duplicated abstracts were independently screened by two authors, resulting in 47 articles. Independent screening of 47 full texts by two authors resulted in a final selection of 40 papers appraising 544 CPGs. DATA EXTRACTION Data were extracted by one author using a pretested Excel form and checked by a second. Key data on the review papers included: purpose, methods used for finding and appraising CPGs, appraising them using AGREE II, and observations and conclusions on CPG quality, specifically applicability. Key data on each CPG included: the 6 AGREE II domain scores and/or 23 item scores, as well as two global evaluations. DATA SYNTHESIS The mean AGREE II Domain scores for the 544 CPGs (all on a 0-100 scale) were Scope and purpose: 72; Stakeholder involvement 53; Rigor of development: 56; Clarity of presentation: 71; Applicability 34 and Editorial independence: 50. Only 36% of CPGs were recommended without modification. The 40 authors generally stated that all or most of the CPGs they appraised were poor or mediocre, especially with respect to Applicability. They only infrequently pointed out what information, going beyond that specified in AGREE II, would enhance applicability. CONCLUSIONS CPGs in principle are an ideal means to move knowledge obtained from clinical research into practice. Our review of reviews of rehabilitation CPGs shows that they commonly have deficits, especially where it comes to applicability. Much work needs to be done by guideline developers to make it easier for the average rehabilitation organization and clinician to implement CPGs in daily practice.

中文翻译:

康复临床实践指南的质量:AGREE II评估的概述研究

目的 评估康复临床实践指南 (CPG) 的质量,特别是其适用性。数据来源 Medline、Embase、Web of Science、CINAHL、PsycINFO、Cochrane 图书馆数据库中搜索了 2017-2019 年发表的论文,这些论文已将研究与评估指南评估 II (AGREE II) CPG 质量评估工具应用于康复 CPG . 研究选择 449 份去重摘要由两位作者独立筛选,最终产生 47 篇文章。两位作者对 47 篇全文进行了独立筛选,最终选出了 40 篇评价 544 个 CPG 的论文。数据提取 数据由一位作者使用预先测试过的 Excel 表格提取并由第二个检查。评论论文的关键数据包括:目的、用于寻找和评估 CPG 的方法、使用 AGREE II 评估它们,以及关于 CPG 质量的观察和结论,特别是适用性。每个 CPG 的关键数据包括:6 个 AGREE II 领域得分和/或 23 个项目得分,以及两个全球评估。数据综合 544 个 CPG(均在 0-100 的范围内)的平均 AGREE II Domain 得分是范围和目的:72;利益相关者的参与 53;开发严谨度:56;呈现清晰度:71;适用性 34 和编辑独立性:50。只有 36% 的 CPG 未经修改就被推荐。40 位作者普遍表示,他们评估的所有或大部分 CPG 都很差或一般,尤其是在适用性方面。他们只是偶尔指出,除了 AGREE II 中规定的信息之外,哪些信息会增强适用性。结论 CPG 原则上是将临床研究中获得的知识转化为实践的理想手段。我们对康复 CPG 的审查表明,它们通常存在缺陷,尤其是在适用性方面。指南制定者需要做很多工作,以使普通康复组织和临床医生更容易在日常实践中实施 CPG。
更新日期:2020-09-01
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