BACKGROUND: Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children's hospitals. The methodological quality of guidelines for priority conditions is unknown. OBJECTIVE: To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. DESIGN: We searched sources including PubMed for national guidelines published from 2002 to 2012. Guidelines specific to 1 organism, test or treatment, or institution were excluded. Guidelines were rated by 2 raters using a validated tool (Appraisal of Guidelines for Research and Evaluation) with an overall rating on a 7-point scale (7 = the highest). Inter-rater reliability was measured with a weighted kappa coefficient. RESULTS: Seventeen guidelines met inclusion criteria for 13 conditions; 7 conditions yielded no relevant national guidelines. The highest methodological-quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5, and 6.5, respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3, respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78-0.87). CONCLUSIONS: We identified a group of moderate to high methodological-quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives.
BACKGROUND: Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children's hospitals. The methodological quality of guidelines for priority conditions is unknown. OBJECTIVE: To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. DESIGN: We searched sources including PubMed for national guidelines published from 2002 to 2012. Guidelines specific to 1 organism, test or treatment, or institution were excluded. Guidelines were rated by 2 raters using a validated tool (Appraisal of Guidelines for Research and Evaluation) with an overall rating on a 7-point scale (7 = the highest). Inter-rater reliability was measured with a weighted kappa coefficient. RESULTS: Seventeen guidelines met inclusion criteria for 13 conditions; 7 conditions yielded no relevant national guidelines. The highest methodological-quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5, and 6.5, respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3, respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78-0.87). CONCLUSIONS: We identified a group of moderate to high methodological-quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives.
Authors: Jeremy Grimshaw; Martin Eccles; Ruth Thomas; Graeme MacLennan; Craig Ramsay; Cynthia Fraser; Luke Vale Journal: J Gen Intern Med Date: 2006-02 Impact factor: 5.128
Authors: Joan Vlayen; Bert Aertgeerts; Karin Hannes; Walter Sermeus; Dirk Ramaekers Journal: Int J Qual Health Care Date: 2005-03-02 Impact factor: 2.038
Authors: Richard M Rosenfeld; Larry Culpepper; Karen J Doyle; Kenneth M Grundfast; Alejandro Hoberman; Margaret A Kenna; Allan S Lieberthal; Martin Mahoney; Richard A Wahl; Charles R Woods; Barbara Yawn Journal: Otolaryngol Head Neck Surg Date: 2004-05 Impact factor: 3.497