RESUMO
BACKGROUND: Clinical practice guidelines (CPGs) are designed to help health professionals provide patients with excellent medical care. The last critical appraisal of CPGs on the treatment of psoriasis evaluated publications up to 2009, but several new guidelines have been published since and their methodological quality remains unclear. OBJECTIVE: The aim of this study was to systematically evaluate the quality of CPGs on the treatment of psoriasis published between 2010 and 2020 using the Appraisal Guidelines Research and Evaluation II (AGREE II) tool. MATERIAL AND METHODS: We searched for relevant CPGs in MEDLINE, Embase, and LILACS (Latin American and Caribean Health Sciences Literature) as well as in the gray literature. Two reviewers working independently selected the guidelines for analysis and extracted the relevant data. Each guideline was then assessed using the AGREE II instrument by 5 reviewers, also working independently. RESULTS: Nineteen CPGs met the inclusion criteria and most of them had been produced in high-income countries. The mean (SD) domain scores were 84.9% (14.7%) for scope and purpose, 65.5% (19.3%) for stakeholder involvement, 66.7% (15.6%) for rigor of development, 72.8% (16.8%) for clarity of presentation, 46.6% (21.7%) for applicability, and 57.0% (30.4%) for editorial independence. CONCLUSIONS: Although about three-quarters of the CPGs assessed were judged to be of high quality and over half were recommended for use in clinical practice, standards of guideline development need to be raised to improve CPG quality, particularly in terms of applicability and editorial independence, which had the lowest scores in our evaluation.
Assuntos
Medicina , Guias de Prática Clínica como Assunto , Psoríase , Humanos , Psoríase/tratamento farmacológicoRESUMO
Introducción: Las guías de práctica clínica (GPCs) se han desarrollado para apoyar a los profesionales de la salud a brindar una excelente atención médica a sus pacientes. Varias GPCs para el tratamiento de psoriasis se han desarrollado desde la última evaluación de calidad de GPCs publicada en 2009 y hasta el momento su calidad metodológica es poco clara. Objetivo: Evaluar sistemáticamente la calidad de GPCs para el tratamiento de psoriasis publicadas en el periodo de 2010-2020, utilizando el instrumento Appraisal Guidelines Research and Evaluation (AGREE II). Material y métodos: Se realizaron búsquedas de GPCs en bases de datos, incluyendo MEDLINE, Embase, LILACS y en la literatura gris. La selección de GPCs y la extracción de datos se realizó de forma independiente por dos revisores. Cinco revisores, aparte, evaluaron las GPCs usando el instrumento AGREE II. Resultados: Diez y nueve GPCs cumplieron con los criterios de inclusión, en su mayoría desarrolladas en países de altos ingresos. Las puntuaciones medias de los dominios fueron: alcance y propósito (84,9% ± 14,7%), participación de las partes interesadas (65,5% ± 19,3%), rigor del desarrollo (66,7% ± 15,6%), claridad de presentación (72,8% ± 16,8%), aplicabilidad (46,6% ± 21,7%), e independencia editorial (57,0% ± 30,4%). Conclusiones: A pesar de que tres cuartos del total de GPCs incluidas fueron clasificadas como de alta calidad y más de la mitad de ellas se recomendaron para la práctica clínica, el desarrollo de las GPCs todavía debe optimizarse para mejorar su calidad. Especialmente en su aplicabilidad e independencia editorial, los cuales fueron los dominios con la puntuación más baja (AU)
Background: Clinical practice guidelines (CPGs) are designed to help health professionals provide patients with excellent medical care. The last critical appraisal of CPGs on the treatment of psoriasis evaluated publications up to 2009, but several new guidelines have been published since and their methodological quality remains unclear. Objective: The aim of this study was to systematically evaluate the quality of CPGs on the treatment of psoriasis published between 2010 and 2020 using the Appraisal Guidelines Research and Evaluation II (AGREE II) tool. Material and methods: We searched for relevant CPGs in MEDLINE, Embase, and LILACS (Latin American and Caribean Health Sciences Literature) as well as in the gray literature. Two reviewers working independently selected the guidelines for analysis and extracted the relevant data. Each guideline was then assessed using the AGREE II instrument by 5 reviewers, also working independently. Results: Nineteen CPGs met the inclusion criteria and most of them had been produced in high-income countries. The mean (SD) domain scores were 84.9% (14.7%) for scope and purpose, 65.5% (19.3%) for stakeholder involvement, 66.7% (15.6%) for rigor of development, 72.8% (16.8%) for clarity of presentation, 46.6% (21.7%) for applicability, and 57.0% (30.4%) for editorial independence. Conclusions: Although about three-quarters of the CPGs assessed were judged to be of high quality and over half were recommended for use in clinical practice, standards of guideline development need to be raised to improve CPG quality, particularly in terms of applicability and editorial independence, which had the lowest scores in our evaluation (AU)
Assuntos
Humanos , Guias de Prática Clínica como Assunto , Psoríase/terapiaRESUMO
Background: Clinical practice guidelines (CPGs) are designed to help health professionals provide patients with excellent medical care. The last critical appraisal of CPGs on the treatment of psoriasis evaluated publications up to 2009, but several new guidelines have been published since and their methodological quality remains unclear. Objective: The aim of this study was to systematically evaluate the quality of CPGs on the treatment of psoriasis published between 2010 and 2020 using the Appraisal Guidelines Research and Evaluation II (AGREE II) tool. Material and methods: We searched for relevant CPGs in MEDLINE, Embase, and LILACS (Latin American and Caribean Health Sciences Literature) as well as in the gray literature. Two reviewers working independently selected the guidelines for analysis and extracted the relevant data. Each guideline was then assessed using the AGREE II instrument by 5 reviewers, also working independently. Results: Nineteen CPGs met the inclusion criteria and most of them had been produced in high-income countries. The mean (SD) domain scores were 84.9% (14.7%) for scope and purpose, 65.5% (19.3%) for stakeholder involvement, 66.7% (15.6%) for rigor of development, 72.8% (16.8%) for clarity of presentation, 46.6% (21.7%) for applicability, and 57.0% (30.4%) for editorial independence. Conclusions: Although about three-quarters of the CPGs assessed were judged to be of high quality and over half were recommended for use in clinical practice, standards of guideline development need to be raised to improve CPG quality, particularly in terms of applicability and editorial independence, which had the lowest scores in our evaluation (AU)
Introducción: Las guías de práctica clínica (GPCs) se han desarrollado para apoyar a los profesionales de la salud a brindar una excelente atención médica a sus pacientes. Varias GPCs para el tratamiento de psoriasis se han desarrollado desde la última evaluación de calidad de GPCs publicada en 2009 y hasta el momento su calidad metodológica es poco clara. Objetivo: Evaluar sistemáticamente la calidad de GPCs para el tratamiento de psoriasis publicadas en el periodo de 2010-2020, utilizando el instrumento Appraisal Guidelines Research and Evaluation (AGREE II). Material y métodos: Se realizaron búsquedas de GPCs en bases de datos, incluyendo MEDLINE, Embase, LILACS y en la literatura gris. La selección de GPCs y la extracción de datos se realizó de forma independiente por dos revisores. Cinco revisores, aparte, evaluaron las GPCs usando el instrumento AGREE II. Resultados: Diez y nueve GPCs cumplieron con los criterios de inclusión, en su mayoría desarrolladas en países de altos ingresos. Las puntuaciones medias de los dominios fueron: alcance y propósito (84,9% ± 14,7%), participación de las partes interesadas (65,5% ± 19,3%), rigor del desarrollo (66,7% ± 15,6%), claridad de presentación (72,8% ± 16,8%), aplicabilidad (46,6% ± 21,7%), e independencia editorial (57,0% ± 30,4%). Conclusiones: A pesar de que tres cuartos del total de GPCs incluidas fueron clasificadas como de alta calidad y más de la mitad de ellas se recomendaron para la práctica clínica, el desarrollo de las GPCs todavía debe optimizarse para mejorar su calidad. Especialmente en su aplicabilidad e independencia editorial, los cuales fueron los dominios con la puntuación más baja (AU)
