Do the clinical practice guidelines for paediatric dentistry meet the quality standards? A meta-research and quality appraisal using AGREE II tool

Abstract

Abstract Background Clinical Practice Guidelines (CPGs) are standardized recommendations to improve healthcare and facilitate clinicians' decisions. We aimed to evaluate the quality of CPGs in paediatric dentistry using the AGREE II tool. Methods PubMed, EMBASE, Scopus, LIVIVO, Lilacs, international guidelines websites, scientific societies, and grey literature databases were searched until September 2021 by two reviewers. We included CPGs that contain paediatric dental recommendations, while drafts or guidelines designed for special needs patients were excluded. Descriptive statistics for the characteristics of the guidelines and mean overall domain scores (95% confidence interval) were calculated. Results Forty-three guidelines were included in this study. Overall mean (95% CI) for all the domains as follows: 1) scope and purpose (49.1%, 95%CI: 41.2–57), 2) stakeholder involvement (32.2%, 95%CI: 24.2–40.1), 3) rigour of development (29%, 95%CI: 22.3–35.7), 4) clarity of presentation (57.3%, 95%CI: 50.2–64.5), 5) applicability (15.8%, 95%CI: 10.4–21.3), and 6) editorial independence (37.7%, 95%CI: 26–49.5). Only one guideline was reported with scores ≥ 60% for all 6 domains. Conclusions The reporting quality of paediatric dentistry guidelines does not meet the standard for methodological quality, especially in domain 5 for applicability. Bias can be introduced during the development of clinical guidelines, which could mislead paediatric dentists and harm patients. Our results could help in establishing good quality CPGs with reliable recommendations by pointing out the importance of implementing the AGREE II tool with a system to evaluate the level of evidence. Registration: The protocol of this study was prospectively registered on Open Science Framework - DOI (10.17605/OSF.IO/BFNGW).