Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of Inflammatory Bowel Disease using the AGREE II instrument: A Systematic Review.

Author:

Zambrano-Sánchez Renato1,Alvarez-Mena Paulina1,Hidalgo Diego2,Liquitay Camila Micaela Escobar3,Franco Juan.V.A.4,Vernooij Robin W.M.5,Simancas-Racines Daniel6,Viteri-García Andrés6,Montesinos-Guevara Camila6

Affiliation:

1. Maestría en Epidemiología con mención en Investigación Clínica Aplicada. Facultad de Ciencias de la Salud Eugenio Espejo. Universidad UTE.

2. Gastroenterology Service Hospital, Hamilton - Alabama

3. Research Department. Instituto Universitario Hospital Italiano de Buenos Aires

4. Institute of General Practice, Heinrich Heine University

5. Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Julius Center for Health Sciences and Primary Care,University Medical Center

6. Centro de Investigación en Epidemiología Clínica y Salud Pública (CISPEC). Facultad de Ciencias de la Salud Eugenio Espejo. Universidad UTE

Abstract

Abstract Background: The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their methodological quality. Therefore, we aimed to systematically evaluate the quality of CPGs for the diagnosis and treatment of IBD using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Methods: We identified CPGs by searching databases (MEDLINE - PubMed, EMBASE, CINAHL, LILACS) and other sources of gray literature on January 2022. We included guidelines with specific recommendations for the diagnosis and treatment of IBD and evaluated them with the AGREE II instrument to assess their methodological quality. Six independent reviewers assessed the quality of the guidelines and resolved conflicts by consensus. We assessed the degree of agreement using the intraclass correlation coefficient (ICC) and change in quality over time was appraised in two periods: from 2012 to 2017 and from 2018 to 2022.Results: We analyzed and evaluated 26 CPGs that met the inclusion criteria. The overall agreement among reviewers was moderate (ICC: 0.74; 95% CI 0.36 - 0.89). The mean scores of the AGREE II domains were: "Scope and purpose" 84.51%, "Stakeholder involvement" 60.90%, "Rigor of development" 69.95%, "Clarity of presentation" 85.58%, "Applicability" 26.60%, and "Editorial independence" 62.02%. No changes in quality were found over time. Conclusions: The quality of the CPGs evaluated was generally good, with a large majority of the assessed guidelines being "recommended" and "recommended with modifications"; despite this, there is still room for improvement, especially in terms of stakeholder involvement and applicability. Efforts to develop high quality CPGs for IBD need to be further optimized.

Publisher

Research Square Platform LLC

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