[Quality analysis of clinical practice guidelines on cardiovascular risks in the Basque country and a proposal for their evaluacion]. / Análisis de calidad de las guías de práctica clínica sobre riesgos cardiovasculares en el País Vasco y propuesta para su evaluación.

ABSTRACT

OBJECTIVES: To find the implantation and quality of clinical practice guidelines (CPG) to manage the major cardiovascular risks tobacco dependency, hypertension, hyperlipaemia and diabetes mellitus. To work out a model to evaluate the quality of the CPG in primary care. DESIGN: Cross-sectional descriptive study. SETTING: The primary care centres of the Basque Country. PARTICIPANTS: 170 CPG used at present to manage the four mentioned cardiovascular risks. MEASUREMENTS AND MAIN RESULTS: Information was requested on the use of CPG and copies of their guidelines were requested from those in charge of 103 ranked centres. 77 centres replied (76%), of which 66 said they used one of them. A total of 170 CPG were received. On the basis of non-specific prior proposals for primary care, 21 quality criteria for the CPG, grouped in 6 blocks, were drawn up. Top quality was found in the block for clarity of clinical procedure with 63% compliance with the CPG, followed by general description (54%), and evaluation and measurement of impact (30%). The blocks with worst compliance were identification of people involved in their design (23%), evidence of their recommendations (19%) and conditions of application (4%). CONCLUSIONS: A model was proposed to evaluate the quality of the CPG. Major deficiencies in quality were found. These were most marked in key aspects such as bibliographic support for their recommendations, envisaging of conditions for application and identification of authors and reviewers.