¿Interesa a los oncólogos incorporarse con entusiasmo al mundo de las guías de práctica clínica? / Is a matter of interest to oncologist to join enthusiastically to the world of clinical practice guides?

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[Are the guidelines guiding us reliable? Evaluation of the Spanish clinical practice guidelines]. / Las guías que nos guían son fiables? Evaluación de las guías de práctica clínica españolas.

BACKGROUND AND OBJECTIVE: There is a large proliferation of clinical practice guidelines (CPG), there being doubts on inconsistencies between the recommendations made and internal incongruencies, that affect the role of the guidelines as instruments helping the clinicians. This study aims to analyze the quality of a group of Spanish CPG and to assess the feasibility of use and consistency of the AGREE Instrument in its Spanish version, designed to evaluate the CPG. METHOD: A total of 278 CPG produced in Spain between January 1990 and December 2002 were identified. The originals of 61 guidelines were recovered from their authors and passed to the AGREE Instrument independently by four raters. Quality of the guidelines feasibility and reproducibility of AGREE were analyzed. RESULTS: For all the attributes of AGREE except in the editorial independence, more than 60% of the guidelines evaluated obtained a poor quality score, there being no domain in which more than 10% of the guidelines was excellent. The worst grading areas are those of applicability, participation and rigour of development of the guidelines. Of the 61 guidelines evaluated, the reviewers graded 25 as "very poor quality", 26 as "non recommendable" and 6 and 4 as "recommendable" or "highly recommendable", respectively. Interrater consistency was high. CONCLUSIONS: The mean quality of the Spanish guidelines evaluated is very low. The AGREE Instrument in its Spanish version is consistent for the Spanish guidelines and easy to use.

¿Las guías que nos guían son fiables? Evaluación de las guías de práctica clínica españolas / Are the guidelines guiding us reliable? Evaluation of the Spanish clinical practice guidelines

Fundamento y objetivo. Hay gran proliferación de guías de práctica clínica (GPC), existiendo dudas sobre inconsistencias entre las recomendaciones que realizan e incongruencias internas que comprometen el papel de las guías como instrumentos de ayuda a los clínicos. El estudio pretende analizar la calidad de un conjunto de GPC españolas, así como valorar la factibilidad de uso y consistencia del Instrumento AGREE en su versión en español, diseñado para la evaluación de GPC. Método. Se identificaron 278 GPC producidas en España entre enero de 1990 y diciembre del 2002. Se recuperaron, mediante solicitud a sus autores, originales de 61 guías a las que se pasó el Instrumento AGREE de forma independiente por cuatro evaluadores. Se analizó la calidad de las guías, la factibilidad y reproducibilidad del AGREE. Resultados. Para todos los atributos del AGREE, excepto en la independencia editorial, más del 60% de las guías evaluadas obtienen una puntuación de mala calidad, no habiendo ningún dominio en el que más del 10% de las guías sea excelente. Las áreas de peor calificación son las de aplicabilidad, participación y rigor en el desarrollo de las guías. De las 61 guías evaluadas, los revisores a 25 las califican de «muy poco recomendables», a 26 de «no recomendables» y tan sólo a 6 y 4 guías como «recomendables» o «muy recomendables», respectivamente. La consistencia entre evaluadores fue alta. Conclusiones. La calidad media de las guías españolas evaluadas es muy baja. El Instrumento AGREE, en su versión en español es consistente para las guías españolas y de uso fácil

Background and objective. There is a large proliferation of clinical practice guidelines (CPG), there being doubts on inconsistencies between the recommendations made and internal incongruencies, that affect the role of the guidelines as instruments helping the clinicians. This study aims to analyze the quality of a group of Spanish CPG and to assess the feasibility of use and consistence of the AGREE Instrument in its Spanish version, designed to evaluate the CPG. Method. A total of 278 CPG produced in Spain between Jannuary 1990 and December 2002 were identified. The originals of 61 guidelines were recovered from their authors and passed to the AGREE Instrument independently by four raters. Quality of the quidelines feasibility and reproducibility of AGREE were analyzed. Results. For all the attributes of AGREE except in the editorial independence, more than 60% of the guidelines evaluated obtained a poor quality score, there being no domain in which more than 10% of the guidelines was excellent. The worst grading areas are those of applicability, participation and rigour of development of the guidelines. Of the 61 guidelines evaluated, the reviewers graded 25 as «very poor quality», 26 as «non recommendable» and 6 and 4 as «recommendable» or «highly recommendable», respectively. Interrater consistency was high. Conclusions. The mean quality of the Spanish guidelines evaluated is very low. The AGREE Instrument in its Spanish version is consistent for the Spanish guidelines and easy to use