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Quality appraisal of clinical practice guidelines on glioma

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An Erratum to this article was published on 24 September 2014

Abstract

Clinical practice guidelines (CPGs) play an important role in healthcare. The guideline development process should be precise and rigorous to ensure that the results are reproducible and not vague. To determine the quality of guidelines, the Appraisal of Guidelines and Research and Evaluation (AGREE) instrument was developed and introduced. The aim of the present study was to assess the methodological quality of clinical practice guidelines on glioma. Eight databases (including MEDLINE and Embase) were searched till to August, 2013. The methodological quality of the guidelines was assessed by four authors independently using the AGREE II instrument. Fifteen relevant guidelines were included from 940 citations. The overall agreement among reviewers was moderate (intra-class correlation coefficient = 0.83; 95 % confidence interval [CI], 0.66–0.92). The mean scores were moderate for the domains “scope and purpose” (59.54) and “clarity of presentation” (65.46); however, there were low scores for the domains “stakeholder involvement” (43.80), “rigor of development” (39.01), “applicability” (31.89), and “editorial independence” (30.83). Only one third of the guidelines described the systematic methods for searching, and nearly half of the (47 %) guidelines did not give a specific recommendation. Only four of 15 described a procedure for updating the guideline; meanwhile, just six guidelines in this field can be considered to be evidence-based. The quality and transparency of the development process and the consistency in the reporting of glioma guidelines need to be improved. And the quality of reporting of guidelines was disappointing. Many other methodological disadvantages were identified. In the future, glioma CPGs should be based on the best available evidence and rigorously developed and reported. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.

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Acknowledgments

The authors would like to acknowledge and extend their heartfelt gratitude to Tang Zhen from University of Bristol for her generous assistance and invaluable advice.

Conflict of interest

There is no financial support or relationships that may pose conflict of interest in this study paper.

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Authors and Affiliations

  1. Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China

    Hongliang Tian

  2. The Second Clinical Medical School of Lanzhou University, Lanzhou, 730000, China

    Yani Gou, Xiaodong Niu & Wentao Liang

  3. Neurosurgery Department, The Second Hospital of Lanzhou University, No. 82, Cui Ying Road, Lanzhou, 730000, Gansu, China

    Yawen Pan, Qiao Li & Yinian Zhang

  4. Basic Medical School of Lanzhou University, Lanzhou, 730000, China

    Dang Wei

  5. The First Clinical Medical School of Lanzhou University, Lanzhou, 730000, China

    Zhenwei Wang

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  1. Hongliang Tian
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Correspondence to Yawen Pan.

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Comments

Rao Sun, Lanzhou, China

Clinical practice guidelines are now a common feature of clinical practice and are of interest worldwide. They are expected to facilitate more consistent, effective, and efficient medical practice and improve health outcomes. Tian Hongliang et al. presented a thorough review which assessed the methodological quality of clinical practice guidelines on glioma. Fifteen relevant guidelines were included in eight databases till August, 2013. The review of published clinical practice guidelines revealed that the quality of reporting of guidelines was disappointing. The mean scores were low for the domains stakeholder involvement (43.80), rigor of development (39.01), applicability (31.89), and editorial independence (30.83). It points out that the future developers of glioma guideline need to pay more attention to these domains during the development process. They are expected to facilitate more consistent, effective, and efficient medical practice and improve health outcomes.

In all, the authors should be encouraged for their significant effort to provide a comprehensive and transparent picture of the glioma guideline. It is the first systematic review of guideline quality over the last 20 years. In the future, glioma guideline should base on the best available evidence and rigorously developed and reported. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.

Tian Hongliang and Gou Yani contributed equally to this study.

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Tian, H., Gou, Y., Pan, Y. et al. Quality appraisal of clinical practice guidelines on glioma. Neurosurg Rev 38, 39–47 (2015). https://doi.org/10.1007/s10143-014-0569-z

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