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A Systematic Critical Appraisal of Clinical Practice Guidelines in Juvenile Idiopathic Arthritis Using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) Instrument.

作者信息

Smith Christine A M, Toupin-April Karine, Jutai Jeffrey W, Duffy Ciarán M, Rahman Prinon, Cavallo Sabrina, Brosseau Lucie

机构信息

School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

PLoS One. 2015 Sep 10;10(9):e0137180. doi: 10.1371/journal.pone.0137180. eCollection 2015.


DOI:10.1371/journal.pone.0137180
PMID:26356098
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4565560/
Abstract

OBJECTIVES: The objectives of this review are to: 1) appraise the methodological quality of clinical practice guidelines (CPGs) in juvenile idiopathic arthritis (JIA) providing pharmacological and/or non-pharmacological intervention recommendations, and 2) summarize the recommendations provided by the included CPGs and compare them where possible. METHODS: A systematic search was performed. Three trained appraisers independently evaluated the methodological quality of the CPGs using a validated and reliable instrument, the Appraisal of Guidelines in Research and Evaluation II. Six domains were considered: 1) score and purpose; 2) stakeholder involvement; 3) rigor of development; 4) clarity of presentation; 5) applicability; and 6) editorial independence. The domains consist of a total of 23 items each scored on a 7-point scale. High quality CPGs were identified if they had a domain score above 60% in rigor of development, and two other domains. RESULTS: Of the three included CPGs, the Royal Australian College of General Practitioners (RACGP) and American College of Rheumatology (ACR) CPGs were considered to be of high quality, but the German Society for Pediatric Rheumatology was of lower quality. Domains one to four had high domain scores across the guidelines (mean (standard deviation)): 72.76 (13.80); 66.67 (9.81); 64.67 (7.77); and 87.00 (9.64), respectively. Lower scores were obtained for applicability (14.00 (5.57)) and editorial independence (43.44 (7.02)). Recommendations varied across CPGs due to differences in context, target audience (general practitioners, rheumatologists, and other multidisciplinary healthcare professionals) and patients' disease presentations. Despite this variability, progression of pharmacological treatment did not conflict between CPGs. Recommendations for non-pharmacological interventions were vague and the interventions considered varied between CPGs. CONCLUSIONS: Overall, recommendations were based on a paucity of evidence and weak study designs. Further research is needed on interventions in JIA, as well as higher quality CPGs to facilitate implementation of the best evidence-based recommendations in clinical practice.

摘要

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本文引用的文献

[1]
Assessment and management of pain in juvenile idiopathic arthritis.

Paediatr Drugs. 2014-12

[2]
Leisure in children and adolescents with juvenile idiopathic arthritis: a systematic review.

PLoS One. 2014-10-20

[3]
A systematic critical appraisal of non-pharmacological management of rheumatoid arthritis with Appraisal of Guidelines for Research and Evaluation II.

PLoS One. 2014-5-19

[4]
High methodologic quality but poor applicability: assessment of the AAOS guidelines using the AGREE II instrument.

Clin Orthop Relat Res. 2014-2-25

[5]
Self-reported pain and disease symptoms persist in juvenile idiopathic arthritis despite treatment advances: an electronic diary study.

Arthritis Rheumatol. 2014-2

[6]
A systematic critical appraisal for non-pharmacological management of osteoarthritis using the appraisal of guidelines research and evaluation II instrument.

PLoS One. 2014-1-10

[7]
Systematic review of guidelines for the physical management of osteoarthritis.

Arch Phys Med Rehabil. 2013-11-1

[8]
2013 update of the 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications.

Arthritis Rheum. 2013-10

[9]
Pain intensity variability and its relationship with quality of life in youths with juvenile idiopathic arthritis.

Arthritis Care Res (Hoboken). 2013-4

[10]
Diagnosis of pheochromocytoma: a clinical practice guideline appraisal using AGREE II instrument.

J Eval Clin Pract. 2012-7-18

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