BACKGROUND: Barrett's esophagus (BE) is a condition that has a small but important risk of progressing to esophageal cancer. To date, no study has assessed the strength of evidence supporting the recommendations for BE. We sought to assess the overall quality of the recommendations and strength of the BE using the AGREE II instrument. METHODS: A PubMed search was performed to identify guidelines published pertaining to BE. Every guideline was reviewed using the AGREE II format to assess the methodological rigor and validity of the guideline. Additionally, guidelines were reviewed for the level of evidence used to support recommendations, conflicts of interest (COI), and differences in recommendations. Statistical analysis was performed using Stata (version 12). RESULTS: In total, 234 manuscripts were identified of which 8 guidelines published between 2005 and 2013 pertained to BE. Seventy-five percentage (6/8) graded the evidence used to formulate recommendations. Of the 126 recommendations with supporting evidence, 6 % were supported by level A evidence, 49 % level B evidence, and 45 % level C evidence. Using the AGREE II format, the highest overall assessment grade was the BSG BE guideline (6.5 ± 0.6) followed by the AGA (5.5 ± 0.6). The highest rated domains were scope and purpose (mean 77 range 24-96) and clarity of presentation (mean 75), while the lowest rated domains were editorial independence (mean 32 range 0-92) and applicability of the guideline (mean 35 range 7-90). There was significant variability in recommendations regarding who to screen for BE and surveillance intervals. Finally, only 50 % of the guidelines disclosed if COI were present and 75 % (3/4) reported potentially relevant COI. CONCLUSIONS: Majority of the BE guideline fail to meet the AGREE II domains, and most of the recommendations are level B or C quality evidence. Further interventions are necessary to improve the overall quality of the guidelines.
BACKGROUND:Barrett's esophagus (BE) is a condition that has a small but important risk of progressing to esophageal cancer. To date, no study has assessed the strength of evidence supporting the recommendations for BE. We sought to assess the overall quality of the recommendations and strength of the BE using the AGREE II instrument. METHODS: A PubMed search was performed to identify guidelines published pertaining to BE. Every guideline was reviewed using the AGREE II format to assess the methodological rigor and validity of the guideline. Additionally, guidelines were reviewed for the level of evidence used to support recommendations, conflicts of interest (COI), and differences in recommendations. Statistical analysis was performed using Stata (version 12). RESULTS: In total, 234 manuscripts were identified of which 8 guidelines published between 2005 and 2013 pertained to BE. Seventy-five percentage (6/8) graded the evidence used to formulate recommendations. Of the 126 recommendations with supporting evidence, 6 % were supported by level A evidence, 49 % level B evidence, and 45 % level C evidence. Using the AGREE II format, the highest overall assessment grade was the BSG BE guideline (6.5 ± 0.6) followed by the AGA (5.5 ± 0.6). The highest rated domains were scope and purpose (mean 77 range 24-96) and clarity of presentation (mean 75), while the lowest rated domains were editorial independence (mean 32 range 0-92) and applicability of the guideline (mean 35 range 7-90). There was significant variability in recommendations regarding who to screen for BE and surveillance intervals. Finally, only 50 % of the guidelines disclosed if COI were present and 75 % (3/4) reported potentially relevant COI. CONCLUSIONS: Majority of the BE guideline fail to meet the AGREE II domains, and most of the recommendations are level B or C quality evidence. Further interventions are necessary to improve the overall quality of the guidelines.
Entities:
Keywords:
Conflicts of interest; Gastroenterology; Practice guidelines
Authors: Melissa C Brouwers; Michelle E Kho; George P Browman; Jako S Burgers; Francoise Cluzeau; Gene Feder; Béatrice Fervers; Ian D Graham; Jeremy Grimshaw; Steven E Hanna; Peter Littlejohns; Julie Makarski; Louise Zitzelsberger Journal: CMAJ Date: 2010-07-05 Impact factor: 8.262
Authors: Joseph D Feuerstein; Anne E Gifford; Mona Akbari; Jonathan Goldman; Daniel A Leffler; Sunil G Sheth; Adam S Cheifetz Journal: Am J Gastroenterol Date: 2013-11 Impact factor: 10.864
Authors: Louisa G Gordon; George C Mayne; Nicholas G Hirst; Timothy Bright; David C Whiteman; David I Watson Journal: Gastrointest Endosc Date: 2013-09-27 Impact factor: 9.427
Authors: Frederik Hvid-Jensen; Lars Pedersen; Asbjørn Mohr Drewes; Henrik Toft Sørensen; Peter Funch-Jensen Journal: N Engl J Med Date: 2011-10-13 Impact factor: 91.245
Authors: Lasse Bremholm; Peter Funch-Jensen; Jan Eriksen; Lene Hendel; Troels Havelund; Peter Matzen Journal: Dan Med J Date: 2012-08 Impact factor: 1.240
Authors: Sahar Tabatabavakili; Rishad Khan; Michael A Scaffidi; Nikko Gimpaya; David Lightfoot; Samir C Grover Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-01-19
Authors: Reza Gholami; Rishad Khan; Anushka Ramkissoon; Abdulrahman Alabdulqader; Nikko Gimpaya; Rishi Bansal; Michael A Scaffidi; Vinay Prasad; Allan S Detsky; Jeffrey P Baker; Samir C Grover Journal: J Can Assoc Gastroenterol Date: 2021-10-21
Authors: Tanja Kovačević; Davorka Vrdoljak; Slavica Jurić Petričević; Ivan Buljan; Dario Sambunjak; Željko Krznarić; Ana Marušić; Ana Jerončić Journal: Int J Environ Res Public Health Date: 2022-08-03 Impact factor: 4.614