Treating schizophrenia: the quality of evidence behind treatment recommendations and how it can improve.
BMJ Evid Based Med
; 25(4): 138-142, 2020 08.
Article
en En
| MEDLINE
| ID: mdl-31672699
ABSTRACT
OBJECTIVE:
To assess the methodological and reporting quality of systematic reviews that comprise the American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients with Schizophrenia and to determine the extent to which results from Cochrane systematic reviews published after guideline development would alter or confirm current recommendations.PARTICIPANTS:
Systematic reviews that underpinned recommendations in the APA guidelines and Cochrane systematic reviews. MAINOUTCOME:
Three independent reviewers scored all systematic reviews referenced in the guideline for quality and reporting using AMSTAR and PRISMA checklist, respectively. Items in both tools were individually graded and compared to identify consistently low-performing areas within the systematic reviews. Post hoc analysis of the Cochrane systematic reviews since the latest revision of APA's guidelines were performed to determine whether their findings were congruent with recent recommendations.RESULTS:
The mean score of the 57 reviews on the PRISMA checklist was 70%. The mean AMSTAR score was 6.8, correlating with a moderate quality score. Post hoc analysis revealed that 171 Cochrane reviews had been published since the APA guideline release. Only half of the reviews of pharmacological interventions confirmed current recommendations. CONCLUSIONS AND RELEVANCE The methodological quality of the systematic reviews included in the APA guideline was deficient in key areas. Our study brings to light the importance of using high-quality evidence in the development of clinical practice guidelines. An updated APA guideline (last updated in 2009) is necessary to provide the highest quality treatment recommendations for clinicians in the management of schizophrenia. TRIAL REGISTRATION NUMBER UMIN-CTR, UMIN000023099.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_geracao_evidencia_conhecimento
Asunto principal:
Esquizofrenia
/
Antipsicóticos
Tipo de estudio:
Guideline
/
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
BMJ Evid Based Med
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos