Mohit Gupta1, John McCauley1, Amy Farkas1, Ahmet Gudeloglu1, Molly M Neuberger2, Yen-Yi Ho3, Lawrence Yeung1, Johannes Vieweg1, Philipp Dahm4. 1. Department of Urology, University of Florida, Gainesville, Florida. 2. Department of Urology, University of Florida, Gainesville, Florida; Urology Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota. 3. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota. 4. Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida; Department of Urology, University of Minnesota, Minneapolis, Minnesota; Urology Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota. Electronic address: pdahm@umn.edu.
Abstract
PURPOSE: Clinical practice guidelines are increasingly being used by leading organizations to promote high quality evidence-based patient care. However, the methodological quality of clinical practice guidelines developed by different organizations varies considerably. We assessed published clinical practice guidelines on the treatment of localized prostate cancer to evaluate the rigor, applicability and transparency of their recommendations. MATERIALS AND METHODS: We searched for English based clinical practice guidelines on treatment of localized prostate cancer from leading organizations in the 15-year period from 1999 to 2014. Clinical practice guidelines limited to early detection, screening, staging and/or diagnosis of prostate cancer were excluded from analysis. Four independent reviewers used the validated AGREE II instrument to assess the quality of clinical practice guidelines in 6 domains, including 1) scope and purpose, 2) stakeholder involvement, 3) rigor of development, 4) clarity of presentation, 5) applicability and 6) editorial independence. RESULTS: A total of 13 clinical practice guidelines met inclusion criteria. Overall the highest median scores were in the AGREE II domains of clarity of presentation, editorial independence, and scope and purpose. The lowest median score was for applicability (28.1%). Although the median score of editorial independence was high (85.4%), variability was also substantial (IQR 12.5-100). NICE and AUA clinical practice guidelines consistently scored well in most domains. CONCLUSIONS: Clinical practice guidelines from different organizations on treatment of localized prostate cancer are of variable quality and fall short of current standards in certain areas, especially in applicability and stakeholder involvement. Improvements in these key domains can enhance the impact and implementation of clinical practice guidelines.
PURPOSE: Clinical practice guidelines are increasingly being used by leading organizations to promote high quality evidence-based patient care. However, the methodological quality of clinical practice guidelines developed by different organizations varies considerably. We assessed published clinical practice guidelines on the treatment of localized prostate cancer to evaluate the rigor, applicability and transparency of their recommendations. MATERIALS AND METHODS: We searched for English based clinical practice guidelines on treatment of localized prostate cancer from leading organizations in the 15-year period from 1999 to 2014. Clinical practice guidelines limited to early detection, screening, staging and/or diagnosis of prostate cancer were excluded from analysis. Four independent reviewers used the validated AGREE II instrument to assess the quality of clinical practice guidelines in 6 domains, including 1) scope and purpose, 2) stakeholder involvement, 3) rigor of development, 4) clarity of presentation, 5) applicability and 6) editorial independence. RESULTS: A total of 13 clinical practice guidelines met inclusion criteria. Overall the highest median scores were in the AGREE II domains of clarity of presentation, editorial independence, and scope and purpose. The lowest median score was for applicability (28.1%). Although the median score of editorial independence was high (85.4%), variability was also substantial (IQR 12.5-100). NICE and AUA clinical practice guidelines consistently scored well in most domains. CONCLUSIONS: Clinical practice guidelines from different organizations on treatment of localized prostate cancer are of variable quality and fall short of current standards in certain areas, especially in applicability and stakeholder involvement. Improvements in these key domains can enhance the impact and implementation of clinical practice guidelines.
Authors: Roderick C N van den Bergh; Piet Ost; Christian Surcel; Massimo Valerio; Jurgen J Fütterer; Giorgio Gandaglia; Prasanna Sooriakumaran; Derya Tilki; Igor Tsaur; Guillaume Ploussard Journal: World J Urol Date: 2018-04-02 Impact factor: 4.226
Authors: Brunno C F Sanches; Ana Luiza Lalli; Wilmar Azal Neto; Athanase Billis; Leonardo Oliveira Reis Journal: World J Urol Date: 2018-03-01 Impact factor: 4.226