An appraisal of clinical practice guidelines for the appropriate use of echocardiography for adult infective endocarditis-the timing and mode of assessment (TTE or TEE).
BMC Infect Dis
; 21(1): 92, 2021 Jan 21.
Article
in En
| MEDLINE
| ID: mdl-33478412
ABSTRACT
BACKGROUND:
Echocardiography (echo) is the primary imaging modality for infective endocarditis (IE). However, the recommendations on timing and mode selection for transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) vary across guidelines, which can be confusing for clinical decision makers. In this case, we aim to appraise the quality of recommendations by appraising the quality of various guidelines.METHODS:
A search of guidelines containing recommendations for the appropriate use of echo in adult IE patients published in English between 2007 and 2019 was conducted. The APPRAISAL OF GUIDELINES FOR RESEARCH & EVALUATION II (AGREE II) instrument was applied independently by two reviewers to assess the integrated quality of the identified guidelines. The recommendations of concern are extracted from related chapters.RESULTS:
A total of 9 guidelines met the criteria, with AGREE II scores ranging from 36 to 79%, and the domain of "stakeholder involvement" received the lowest score. The most contentious issue is whether a follow-up TEE is mandatory in uncomplicated native valve IE with an initial positive TTE. Conflicting recommendations are presented with a low evidence level based on little evidence.CONCLUSIONS:
In general, the recommendations proposed in the 9 identified guidelines on the appropriate use of echo are satisfying. The guideline quality score can be taken into account by the clinicians when evaluating the recommendations for clinical decisions. Additional studies with high evidence level should be conducted on the most controversial issues of whether a subsequent TEE is mandatory in uncomplicated native valve IE with an initial positive TTE.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Echocardiography
/
Practice Guidelines as Topic
/
Endocarditis
Type of study:
Guideline
/
Prognostic_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
BMC Infect Dis
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2021
Type:
Article