Migrant Healthcare Guidelines: A Systematic Quality Assessment
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Significant international and cross-border migration has led to a growing availability of migrant healthcare guidelines (MHGs), which we systematically reviewed for quality. PubMed, MEDLINE, CINHAL, PsychINFO and guideline developer/guideline databases were searched for MHGs published 2006–2016. Three independent reviewers assessed eligible MHGs using the Appraisal of Guidelines, Research and Evaluation II instrument (AGREE II). MHGs were identified as high quality if they had a score of ≥ 60% in at least three of the six domains, including “rigour of development”, and overall quality was assessed on a seven-point Likert scale. We included 32 MHGs. Overall agreement between reviewers was very good. Mean scores for each AGREE II domain were as follows: 85 ± 19.0% for “scope and purpose”; 51 ± 30.5% for “stakeholder involvement”; 34 ± 31.9% for “rigour of development”; 86 ± 7.3% for “clarity of presentation”; 40 ± 23.6% for “applicability”; and 27 ± 38.5% for “editorial independence”. Nine and six MHGs were deemed “recommended” or “recommended with modifications”, respectively, and 17 were “not recommended”. Our review of MHGs has highlighted critical deficiencies in rigour of development, applicability, editorial independence and stakeholder involvement that point to the need for improvements in future MHGs.
KeywordsMigrant health Refugee health Practice guidelines AGREE II tool Quality assessment
EA is a doctoral candidate for the PhD in Methodology of Biomedical Research and Public Health (Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine), Universidad Autònoma de Barcelona, Barcelona, Spain. Also, we acknowledge Ailish M J Maher, a medical writer/editor for providing important edits to the writing ad presentation of the manuscript to improve clarity.
EA and PAC contributed to the conceptualization, design and conduct of the study. EA, IS and PF contributed to the search strategy design, searching and screening. EA and IA performed data extraction with input from PF. EA, IA and LH evaluated the MHGs using the AGREE II tool. EA performed data analysis with input from PF and PAC. EA, IS, PF and PAC interpreted the data. EA wrote the initial draft of the manuscript, which was then added to and edited in subsequent iterations with PAC, PF, KP. All authors reviewed and approved the final manuscript.
There was no specific funding support for this study. PAC received support via a Miguel Servet investigator Contract from the Instituto de Salud Carlos III (CPII15/0034).
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no competing interests.
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