Atle Fretheim1, John W Williams, Andrew D Oxman, Jeph Herrin. 1. Department of Health Services Research, Norwegian Directorate for Health Social Welfare, PO Box 8054 Dep, N-0031 Oslo, Norway. atle.fretheim@shdir.no
Abstract
OBJECTIVE: To assess the association between methods used to develop clinical practice guidelines and the recommendations that are made. STUDY DESIGN: Systematic review of clinical practice guidelines for hypertension or hyperlipidemia. OUTCOMES MEASURED: Two people independently appraised guideline methods by using 8 criteria and the aggressiveness of recommendations for treatment thresholds, initial drug selection, and screening. RESULTS: We identified 33 guidelines. Only 6 fulfilled 5 or more of the 8 criteria. For 5 of the criteria, fewer than 50% of the guidelines fulfilled those criteria. There was wide variation in recommendations for treatment thresholds, drug selection, and cholesterol screening. Guidelines that did not fulfill the criteria tended to suggest more aggressive recommendations than did guidelines that met the criteria. For 6 of the 8 criteria, guidelines published by specialty societies were less likely to fulfill them compared with guidelines not published by specialty societies. CONCLUSIONS: Guideline developers who did not use rigorous methods tended to promote intervening more aggressively for hypertension and hyperlipidemia.
OBJECTIVE: To assess the association between methods used to develop clinical practice guidelines and the recommendations that are made. STUDY DESIGN: Systematic review of clinical practice guidelines for hypertension or hyperlipidemia. OUTCOMES MEASURED: Two people independently appraised guideline methods by using 8 criteria and the aggressiveness of recommendations for treatment thresholds, initial drug selection, and screening. RESULTS: We identified 33 guidelines. Only 6 fulfilled 5 or more of the 8 criteria. For 5 of the criteria, fewer than 50% of the guidelines fulfilled those criteria. There was wide variation in recommendations for treatment thresholds, drug selection, and cholesterol screening. Guidelines that did not fulfill the criteria tended to suggest more aggressive recommendations than did guidelines that met the criteria. For 6 of the 8 criteria, guidelines published by specialty societies were less likely to fulfill them compared with guidelines not published by specialty societies. CONCLUSIONS: Guideline developers who did not use rigorous methods tended to promote intervening more aggressively for hypertension and hyperlipidemia.
Authors: Cheryl L L Carling; Doris Tove Kristoffersen; Andrew D Oxman; Signe Flottorp; Atle Fretheim; Holger J Schünemann; Elie A Akl; Jeph Herrin; Thomas D MacKenzie; Victor M Montori Journal: PLoS One Date: 2010-03-01 Impact factor: 3.240
Authors: Fiona Campbell; Heather O Dickinson; Julia V F Cook; Fiona R Beyer; Martin Eccles; James M Mason Journal: BMC Health Serv Res Date: 2006-04-05 Impact factor: 2.655
Authors: Ulrich Siering; Michaela Eikermann; Elke Hausner; Wiebke Hoffmann-Eßer; Edmund A Neugebauer Journal: PLoS One Date: 2013-12-09 Impact factor: 3.240