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Quality Assessment of a Clinical Guidelines Czech Neurological Society


Authors: R. Líčeník 1,2;  K. Kliková 1;  D. Osinová 1;  S. Doubravská 2;  K. Ivanová 1
Authors‘ workplace: Centrum pro klinické doporučené postupy, Ústav sociálního lékařství a zdravotní politiky LF UP v Olomouci 1;  Hyper-acute stroke unit, Northwick Park Hospital, Londýn 2
Published in: Cesk Slov Neurol N 2014; 77/110(1): 64-69
Category: Original Paper

Overview

Aim:
The aim of this study was to evaluate the quality of a new set of clinical practice guidelines developed by the Czech Neurological Society between 2009 and 2012 using the methodology developed by the National Reference Centre.

Methods:
Six neurological clinical practice guidelines were evaluated by four independent reviewers with AGREE II instrument in six domains: scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence.

Results:
All evaluated clinical practice guidelines were of high quality with the mean of 93.5% for the total score domain. The guidelines had high scores in the clarity and recommendations and applicability (99.6%), scope and purpose (99.0%), rigour of development (97.6%) and stakeholder involvement (97.1%). The lowest score was in editorial independence (47.5%).

Conclusions:
The overall quality of neurology clinical practice guidelines was high. The methodology of development and support for developers was robust, systematic and standardised. To maintain the quality of development of clinical practice guidelines in the future it is crucial to continue using a comprehensive and validated development framework. The quality of guidelines can be improved by increasing stakeholder involvement, continuous and systematic assessment of their quality and content and their impact on inputs, processes and outcomes of health care as well as ensuring their effective implementation.

Key words:
practice guidelines – quality indicators – standards of care – evaluation studies – neurology

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


Sources

1. Field MJ, Lohr KN. Clinical practice guidelines: Directions for a new program. Washington, D.C.: National Academy Press 1990: 38.

2. Burls A. AGREE II-improving the quality of clinical care. Lancet 2010; 376(9747): 1128–1129.

3. Weisz G, Cambrosio A, Keating P, Knaapen L, Schlich T, Tournay VJ. The emergence of clinical practice guidelines. Milbank Q 2007; 85(4): 691–727.

4. Ollenschläger G, Marshall C, Qureshi S, Rosenbrand K, Burgers J, Makela M et al. Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network(G-I-N). Qual Saf Health Care 2004; 13(6): 455–460.

5. Grimshaw JM, Hutchinson A. Clinical practice guide­lines – do they enhance value for money in health care? British Medical Bulletin 1995; 51(4): 927–940.

6. Institute of Medicine. Guidelines for clinical practice: from development to use. Washington, D.C.: National Academy Press 1992.

7. Cluzeau F, Littlejohns P, Grimshaw J, Hopkins A. Appraising clinical guidelines and the development of criteria – a pilot study. J Interprof Care 1995; 9(3): 227–235.

8. Cluzeau F, Littlejohns P, Grimshaw J, Feder G, Moran S. Development and application of a generic methodology to assess the quality of clinical guidelines. Int J Qual Health Care 1999; 11(1): 21–28.

9. Cluzeau F, Burgers J, Brouwers M, Grol R, Makela M, Littlejohns P et al; AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care 2003; 12(1): 18–23.

10. Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ 2010; 182(18): E839–E842.

11. Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G et al. Development of the AGREE II, part 1: performance, usefulness and areas for improvement. CMAJ 2010; 182(10): 1045–1052.

12. Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G et al. Development of the AGREE II, part 2: assessment of validity of items and tools to support application. CMAJ 2010; 182(10): E472–E478.

13. Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S,van der Wees P; Board of Trustees of the Guidelines International Network. Guidelines International Network: toward international standards for clinical practice guidelines. Ann Intern Med 2012; 156(7): 525–531.

14. Suchý M, Bednařík J, Škoda O, Voháňka S, Ehler E, Pátá M et al. Vývoj Národní sady klinických standardů a ukazatelů zdravotní péče a první výsledky v oboru neurologie. Cesk Slov Neurol N 2010; 73/106(5): 569–577.

15. Líčeník R. Klinické doporučené postupy I. Obecné zásady, principy tvorby a adaptace. Olomouc: Univerzita Palackého v Olomouci 2009: 24–31.

16. Bednařík J, Suchý M, Ehler E. Klinické standardy v české neurologii – historie a současnost. Cesk Slov Neurol N 2011; 74/107 (Suppl): S50.

17. Líčeník R, Kurfürst P, Ivanová K. AGREE II: Nástroj pro hodnocení doporučených postupů pro výzkum a evaluaci. Olomouc: Univerzita Palackého v Olomouci 2013.

18. Piťha J, Bednařík J, Zapletalová O, Schützner J, Zámečník J, Ambler Z et al. Klinický standard pro diagnostiku a léčbu myasthenia gravis. Cesk Slov Neurol N 2012; 75/108(2): 242–252.

19. Bednařík J, Voháňka S, Ehler E, Ambler Z, Piťha J, Vencovský J et al. Standard pro léčbu pacientů s autoimunitním nervosvalovým onemocněním intravenózním lidským imunoglobulinem a plazmaferézou. Cesk Slov Neurol N 2010; 73/106(5): 579–589.

20. Bednařík J, Ambler Z, Opavský J, Keller O, Rokyta R, Mazanec R et al. Klinický standard pro farmakoterapii neuropatické bolesti. Cesk Slov Neurol N 2012; 75/108(1): 93–101.

21. Šonka K, Nevšímalová S. Klinický standard pro diagnostiku a léčbu narkolepsie. Cesk Slov Neurol N 2011; 74 (Suppl): S51.

22. Suchý M, Bednařík J. Klinické doporučené postupy v neurologii I Olomouc: Univerzita Palackého v Olomouci 2012.

23. Školoudík D, Bar M, Mikulík R, Neumann J, Václavík D, Herzig R et al. Standard pro podání systémové trombolýzy pacientům s akutním mozkovým infarktem. Cesk Slov Neurol N 2006; 69/102(2): 151–156.

24. Neumann J, Mikulík R, Václavík D, Školoudík D. Standard pro diagnostiku a léčbu pacientů po tranzitorní ischemické atace. Cesk Slov Neurol N 2006; 69/102(3): 326–330.

25. Mikulík R, Neumann J, Václavík D, Školoudík D. Standard pro diagnostiku a léčbu pacientů s mozkovým infarktem. Cesk Slov Neurol N 2006; 69/102(3): 320–325.

26. Ehler E. Aspekty tvorby klinických doporučených postupů v oboru neurologie podle národní metodiky. Cesk Slov Neurol N 2010; 73/106(5): 568.

27. Guyatt G, Akl EA, Hirsh J, Kearon C, Crowther M, Gutterman D et al. The vexing problem of guidelines and conflict of interest: a potential solution. Ann Intern Med 2010; 152(11): 738–741.

28. De Hert M, Vancampfort D, Correll CU, Mercken V, Peuskens J, Sweers K et al. Guidelines for screening and monitoring of cardiometabolic risk in schizophrenia: systematic evaluation. Br J Psychiatry 2011; 199(2): 99–105.

29. Lugtenberg M, Burgers JS, Westert GP. Effects of evidence-based clinical practice guidelines on quality of care: a systematic review. Qual Saf Health Care 2009; 18(5): 385–392.

30. Klikova K, Licenik R, Mihal V. Clinical practice guide­lines in paediatrics in the Czech Republic. BMJ Qual Saf 2013; 22 (Suppl 1): A62.

31. Licenik R, Klikova K, Osinova D, Doubravska S, Ivanova K. Ethical principles in guidelines. It is never ending story. BMJ Qual Saf 2013; 22 (Suppl 1): A14.

32. Burda BU, Norris SL, Holmer HK, Ogden LA, Smith ME. Quality varies across clinical practice guidelines for mammography screening in women aged 40–49 years as assessed by AGREE and AMSTAR instruments. J Clin Epidemiol 2011; 64(9): 968–976.

33. Boluyt N, Lincke CR, Offringa M. Quality of evidence-based pediatric guidelines. Pediatrics 2005; 115(5): 1378–1391.

34. Pentheroudakis G, Stahel R, Hansen H, Pavlidis N. Heterogeneity in cancer guidelines: should we eradicate or tolerate? Ann Oncol 2008; 19(12): 2067–2078.

35. Bennett WL, Odelola OA, Wilson LM, Bolen S, Selvaraj S, Robinson KA et al. Evaluation of guideline recommendations on oral medications for type 2 diabetes mellitus: a systematic review. Ann Intern Med 2012; 156(1): 27–36.

36. Stone MA, Wilkinson JC, Charpentier G, Clochard N, Grassi G, Lindblad U et al. Evaluation and comparison of guidelines for the management of people with type 2 diabetes from eight European countries. Diabetes Res Clin Practearch 2010; 87(2): 252–260.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 1

2014 Issue 1

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