External review of the SBC Guidelines according to the AGREE II tool - Do we need to review our Guidelines?

Authors

DOI:

https://doi.org/10.17267/2675-021Xevidence.2022.e3930

Keywords:

Guideline [Publication Type], Methods, Cardiology

Abstract

INTRODUCTION: Clinical guidelines should be systematically prepared documents that aim primarily to provide the best available medical information to support the decisions of patients and health professionals. Managers can also use them for the formulation of public policies. OBJECTIVE: To evaluate the methodological quality of three clinical guidelines of the Brazilian Society of Cardiology (SBC) according to an internationally accepted tool for this purpose and suggest improvements to the preparation of such documents. METHODS: Twelve independent evaluators (four per document) used the AGREE II tool to methodologically evaluate three clinical guidelines of the SBC that address issues of extreme importance and prevalence in the human population: arterial hypertension, diabetes, and dyslipidaemia. RESULTS: According to the evaluations of the three guidelines, due to the low scores received in the domains Stakeholder Involvement, Applicability of the Guideline, and, especially, Rigor of Development, two of them were deemed to have an unsatisfactory elaboration method. CONCLUSION: The methodological quality of the clinical guidelines of the SBC was deemed unsatisfactory. In this article, we suggest strategies to improve the process of preparing future documents.

Downloads

Download data is not yet available.

References

AGREE: Advancing the science of practice guidelines [Internet]. Available from: http://www.agreetrust.org

Sociedade Brasileira de Cardiologia. Edital de convocação para a prova de título de especialista em cardiologia. Sociedade Brasileira de Cardiologia; 2018. Available from: http://educacao.cardiol.br/cjtec/pdf/2018/TEC2018_edital_versaofinal_maio2018%20_divulgar_importante.pdf

Burgers JS, Fervers B, Haugh M, Brouwers M, Browman G, Philip T, et al. International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation Instrument. J Clin Oncol. 2004;22(10):2000-7. https://doi.org/10.1200/JCO.2004.06.157

Shaneyfelt TM, Mayo-Smith MF, Rothwangl J. Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer-reviewed medical literature. JAMA. 1999;281(20):1900-5. https://doi.org/10.1001/jama.281.20.1900

Sociedade Brasileira de Cardiologia. Normas para elaboração de diretrizes [Internet]. Sociedade Brasileira de Cardiologia. Available from: http://publicacoes.cardiol.br/2014/diretrizes/pdf/normas-para-elaboracao-de-diretrizes-SBC.pdf

Equator Network: Enhancing the quality and transparency of health research [Internet]. Available from: http://www.equator-network.org

Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa ADM, et al. Diretrizes Brasileiras de Hipertensão Arterial. Arq Bras Cardiol. 2021;116(3):516-658. https://doi.org/10.36660/abc.20201238

Faludi AA, Izar MCO, Saraiva JFK, Bianco HT, Chacra APM, Bertoluci MC, et al. Diretriz brasileira baseada em evidências sobre prevenção de doenças cardiovasculares em pacientes com diabetes: posicionamento da Sociedade Brasileira de Diabetes (SBD), da Sociedade Brasileira de Cardiologia (SBC) e da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM). Arq Bras Cardiol. 2017;109(6 suppl 1):1-31. https://doi.org/10.5935/abc.20170188

Faludi AA, Izar MCO, Saraiva JFK, Chacra APM, Bianco HT, Afiune Neto A, et al. Atualização da diretriz brasileira de dislipidemias e prevenção da aterosclerose – 2017. Arq Bras Cardiol. 2017;109(2):1-76. https://doi.org/10.5935/abc.20170121

Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999;318(7182):527-30. https://doi.org/10.1136/bmj.318.7182.527

Shiffman RN, Shekelle P, Overhage JM, Slutsky J, Grimshaw J, Deshpande AM. Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline Standardization. Ann Intern Med. 2003;139(6):493-8. https://doi.org/10.7326/0003-4819-139-6-200309160-00013

Mion Junior DM, Carvalho JGR, Nobre F, Furtado MR, Ramires JAF, Junior OK. II Consenso Brasileiro para o tratamento da hipertensão arterial. Arq Bras Cardiol [Internet]. 1994;63(4):333-47. Available from: http://publicacoes.cardiol.br/portal/portal-publicacoes//Pdfs/ABC/1994/6304/Consenso_TrataHA.pdf

Grilli R, Magrini N, Penna A, Mura G, Liberati A. Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet. 2000;355(9198):103-6. https://doi.org/10.1016/S0140-6736(99)02171-6

Burgers JS, Bailey JV, Klazinga NS, Van der Bij AK, Grol R, Feder G. Inside guidelines: comparative analysis of recommendations and evidence in diabetes guidelines from 13 countries. Diabetes care. 2002;25(11):1933-9. https://doi.org/10.2337/diacare.25.11.1933

Raine R, Sanderson C, Hutchings A, Carter S, Larkin K, Black N. An experimental study of determinants of group judgments in clinical guideline development. Lancet. 2004;364(9432):429-37. https://doi.org/10.1016/S0140-6736(04)16766-4

Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S, van der Wees P. Guidelines International Network: toward international standards for clinical practice guidelines. Ann. Intern. Med. 2012;156(7):525-31. https://doi.org/10.7326/0003-4819-156-7-201204030-00009

Institute of Medicine. Clinical practice guidelines we can trust [Internet]. Washington, DC: The National Academies Press; 2011. https://doi.org/10.17226/13058

Department of Health & Human Care (United States). National Guideline Clearinghouse (NGC) Inclusion Research and Quality (AHRQ) [Internet]. US: Department of Health & Human Care; 2014. Available from: https://www.ahrq.gov/gam/summaries/inclusion-criteria/index.html

Ministério da Saúde (Brasil). Diretrizes metodológicas: Sistema GRADE - Manual de graduação da qualidade da evidência e força de recomendação para tomada de decisão em saúde [Internet]. Brasília: Ministério da Saúde; 2014. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_sistema_grade.pdf

Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S, et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004;4(1):38. https://doi.org/10.1186/1472-6963-4-38

Atkins D, Briss PA, Eccles M, Flottorp S, Guyatt GH, Harbour RT, et al. Systems for grading the quality of evidence and the strength of recommendations II: pilot study of a new system. BMC Health Serv Res. 2005;5(1):25. https://doi.org/10.1186/1472-6963-5-25

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ-Brit Med J. 2008;336(7650):924-6. https://doi.org/10.1136/bmj.39489.470347.AD

Group GW. Grading quality of evidence and strength of recommendations. BMJ-Brit Med J. 2004;328(7454):1490. https://doi.org/10.1136/bmj.328.7454.1490

Wolf SJ, Lo B, Shih RD, Smith MD, Fesmire FM. Clinical policy: critical issues in the evaluation and management of adult patients in the emergency department with asymptomatic elevated blood pressure. Ann Emerg Med. 2013;62(1):59-68. https://doi.org/10.1016/j.annemergmed.2013.05.012

Huang X, Lin J, Demner-Fushman D. Evaluation of PICO as a knowledge representation for clinical questions. AMIA Annu Symp Proc. 2006;2006:359-63. Cited: PMID: 17238363

Cochrane Library [Internet]. Available from: https://www.cochranelibrary.com

Preventive Services Task Force [Internet]. Available from: https://www.uspreventiveservicestaskforce.org

Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(6):1269-324. https://doi.org/10.1161/HYP.0000000000000066

Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2017(2):1-113. https://doi.org/10.1002/14651858.MR000033.pub3

Published

01/07/2022

Issue

Section

Research Articles

How to Cite

1.
Luna LC, Magliano CA, dos Santos RM, de Almeida BM, Fatorelli A, Barata R de S, et al. External review of the SBC Guidelines according to the AGREE II tool - Do we need to review our Guidelines?. Evidence [Internet]. 2022 Jan. 7 [cited 2024 Nov. 24];4:e3930. Available from: https://www5.bahiana.edu.br/index.php/evidence/article/view/3930

Most read articles by the same author(s)

<< < 1 2 3 4 5 6 7 8 9 10 > >>