Scientific evidence underlying the recommendations of critical care clinical practice guidelines: a lack of high level evidence
Clinical practice guidelines (CPG) are widely used in critical care medicine (CCM). This study aimed to investigate the distributions of grade of evidence and recommendation in CCM, as well as factors influencing the recommendation classes. We hypothesized that the grade of evidence and publication year were independent determinants of the recommendation classes.
Electronic databases of PubMed and Scopus were searched from inception to March 2017 (details in Supplemental Material 1). CPGs in CCM developed under the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework were included. Data on the following variables were extracted: year of publication, topic of the CPG, recommendation class, and the grade of evidence. Grade levels A, B, C, and D correspond to high, moderate, low, and very low quality of evidence. To examine independent predictors of the recommendation class, a binary logistic regression model was constructed by incorporating variables...
The study was funded by Zhejiang Engineering Research Center of Intelligent Medicine (2016E10011) from the First Affiliated Hospital of Wenzhou Medical University and Zhejiang Provincial Natural Science Foundation of China (LGF18H150005).
Compliance with ethical standards
The study did not involve human participants and ethics approval is not applicable.
Conflicts of interest
The authors declare that they have no competing interests.