D E S Larenas-Linnemann1, D Antolín-Amérigo2,3, C Parisi4, A Nakonechna5, J A Luna-Pech6, B Wedi7, I Davila8, M Gómez9, M Levin10, J A Ortega Martell11, L Klimek12, N Rosario13, A M Muraro14, I Agache15, J Bousquet16, A Sheikh17, O Pfaar12,18. 1. Investigational Unit, Hospital Medica Sur, Mexicocity, Mexico. 2. Servicio de Enfermedades del Sistema Inmune-Alergia, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain. 3. Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, Spain. 4. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 5. Royal Liverpool University Hospital and Liverpool Hope University, Liverpool, United Kingdom. 6. Universidad de Guadalajara, Guadalajara, Mexico. 7. Hannover Medical School, Hannover, Germany. 8. University Hospital of Salamanca, Salamanca, Spain. 9. Fundación Ayre (Education & Research), Salta, Argentina. 10. Red Cross Children's Hospital and School of Adolescent and Child Health, University of Cape Town, Cape Town, South Africa. 11. Universidad de Hidalgo, Pachuca, Mexico. 12. Center for Rhinology and Allergology, Wiesbaden, Germany. 13. Universidade Federal do Paraná, Curitiba, Brazil. 14. Padua University, Padua, Italy. 15. Department of Allergy & Clinical Immunology, Transylvania University, Brasov, Romania. 16. MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France. 17. Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK. 18. Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Abstract
BACKGROUND: Since 1988, numerous allergen immunotherapy guidelines (AIT-GLs) have been developed by national and international organizations to guide physicians in AIT. Even so, AIT is still severely underused. OBJECTIVE: To evaluate AIT-GLs with AGREE-II, developed in 2010 by McMaster University methodologists to comprehensively evaluate GL quality. METHODS: Allergist, from different continents, knowledgeable in AIT and AGREE-II trained were selected into the project team. The project received methodologists' guidance. AIT-GLs in any language were sought from 1980 to 2016; AIT-GLs were AGREE II-evaluated by at least 2 team members, independently; discrepancies were resolved in a second round, by team discussion or methodologists' consulting. RESULTS: We found 31 AIT-GLs (15 post-2010), ranging from local consensus reports to international position papers (EAACI, AAAAI-ACAAI, WAO). Pre-2010 GLs scored 1.6-4.6 (23%-67%) and post-2010 GLs scored 2.1-6 (30%-86%), on a 7-point Likert scale. The highest scores went to: German-Austrian-Swiss (6.0), Mexican (5.1), and the AAAAI/ACAAI AIT-GL (4.7). These were also the only 3 GLs that received "yes" of both evaluators to the item: "I would recommend this GL for use." The domains of "Stakeholder involvement" and "Rigor of Development" only scored 3/7, and "Applicability" scored the lowest. Strikingly, newer GLs only scored clearly better in "Editorial independence" and "Global evaluation." CONCLUSIONS: In AIT-GLs, there is still a lot of room for improvement, especially in domains crucial for the dissemination. For some GLs, the "Scientific rigor" domain flawed. When resources are limited, transculturizing a high-quality GL might be preferable over developing a GL from zero. Our study and AGREE-II could help to select the best candidate. CLINICAL IMPLICATIONS: We here evaluate allergen immunotherapy guideline (AIT-GL) quality. Only high-quality AIT-GLs should be consulted for AIT management decisions. In low-resource settings, transculturization of these is preferred over developing low-quality guidelines.
BACKGROUND: Since 1988, numerous allergen immunotherapy guidelines (AIT-GLs) have been developed by national and international organizations to guide physicians in AIT. Even so, AIT is still severely underused. OBJECTIVE: To evaluate AIT-GLs with AGREE-II, developed in 2010 by McMaster University methodologists to comprehensively evaluate GL quality. METHODS: Allergist, from different continents, knowledgeable in AIT and AGREE-II trained were selected into the project team. The project received methodologists' guidance. AIT-GLs in any language were sought from 1980 to 2016; AIT-GLs were AGREE II-evaluated by at least 2 team members, independently; discrepancies were resolved in a second round, by team discussion or methodologists' consulting. RESULTS: We found 31 AIT-GLs (15 post-2010), ranging from local consensus reports to international position papers (EAACI, AAAAI-ACAAI, WAO). Pre-2010 GLs scored 1.6-4.6 (23%-67%) and post-2010 GLs scored 2.1-6 (30%-86%), on a 7-point Likert scale. The highest scores went to: German-Austrian-Swiss (6.0), Mexican (5.1), and the AAAAI/ACAAI AIT-GL (4.7). These were also the only 3 GLs that received "yes" of both evaluators to the item: "I would recommend this GL for use." The domains of "Stakeholder involvement" and "Rigor of Development" only scored 3/7, and "Applicability" scored the lowest. Strikingly, newer GLs only scored clearly better in "Editorial independence" and "Global evaluation." CONCLUSIONS: In AIT-GLs, there is still a lot of room for improvement, especially in domains crucial for the dissemination. For some GLs, the "Scientific rigor" domain flawed. When resources are limited, transculturizing a high-quality GL might be preferable over developing a GL from zero. Our study and AGREE-II could help to select the best candidate. CLINICAL IMPLICATIONS: We here evaluate allergen immunotherapy guideline (AIT-GL) quality. Only high-quality AIT-GLs should be consulted for AIT management decisions. In low-resource settings, transculturization of these is preferred over developing low-quality guidelines.
Authors: Ayşe Arzu Yorgancıoğlu; Bilun Gemicioğlu; Cemal Cingi; Ömer Kalaycı; Ali Fuat Kalyoncu; Claus Bachert; Peter Hellings; Oliver Pfaar; Holger J Schünemann; Dana Wallace; Anna Bedbrook; Wienczyslawa Czarlewski; Jean Bousquet Journal: Turk Thorac J Date: 2020-03-01
Authors: Oliver Pfaar; Tobias Ankermann; Matthias Augustin; Petra Bubel; Sebastian Böing; Randolf Brehler; Peter A Eng; Peter J Fischer; Michael Gerstlauer; Eckard Hamelmann; Thilo Jakob; Jörg Kleine-Tebbe; Matthias Volkmar Kopp; Susanne Lau; Norbert Mülleneisen; Christoph Müller; Katja Nemat; Wolfgang Pfützner; Joachim Saloga; Klaus Strömer; Peter Schmid-Grendelmeier; Antje Schuster; Gunter Johannes Sturm; Christian Taube; Zsolt Szépfalusi; Christian Vogelberg; Martin Wagenmann; Wolfgang Wehrmann; Thomas Werfel; Stefan Wöhrl; Margitta Worm; Bettina Wedi; Susanne Kaul; Vera Mahler; Anja Schwalfenberg Journal: Allergol Select Date: 2022-09-06
Authors: Désirée Larenas-Linnemann; Noel Rodríguez-Pérez; Jorge A Luna-Pech; Mónica Rodríguez-González; María Virginia Blandón-Vijil; Blanca E Del-Río-Navarro; María Del Carmen Costa-Domínguez; Elsy Maureen Navarrete-Rodríguez; Carlos Macouzet-Sánchez; José Antonio Ortega-Martell; César Fireth Pozo-Beltrán; Alan Estrada-Cardona; Alfredo Arias-Cruz; Karen Guadalupe Rodríguez Galván; Herson Brito-Díaz; María Del Rosario Canseco-Raymundo; Enrique Emanuel Castelán-Chávez; Alberto José Escalante-Domínguez; José Luis Gálvez-Romero; Javier Gómez-Vera; Sandra Nora González-Díaz; María Gracia Belinda Guerrero-Núñez; Dante Daniel Hernández-Colín; Alejandra Macías-Weinmann; David Alejandro Mendoza-Hernández; Néstor Alejandro Meneses-Sánchez; María Dolores Mogica-Martínez; Carol Vivian Moncayo-Coello; Juan Manuel Montiel-Herrera; Patricia María O'Farril-Romanillos; Ernesto Onuma-Takane; Margarita Ortega-Cisneros; Lorena Rangel-Garza; Héctor Stone-Aguilar; Carlos Torres-Lozano; Edna Venegas-Montoya; Guillermo Wakida-Kusunoki; Armando Partida-Gaytán; Aída Inés López-García; Ana Paola Macías-Robles; María de Jesús Ambriz-Moreno; Amyra Ali Azamar-Jácome; Claudia Yusdivia Beltrán-De Paz; Chrystopherson Caballero-López; Juan Carlos Fernández de Córdova-Aguirre; José Roberto Fernández-Soto; José Santos Lozano-Sáenz; José Joel Oyoqui-Flores; Roberto Efrain Osorio-Escamilla; Fernando Ramírez-Jiménez; Daniela Rivero-Yeverino; Eric Martínez Infante; Miguel Alejandro Medina-Ávalos Journal: World Allergy Organ J Date: 2020-08-21 Impact factor: 4.084
Authors: Heimo Breiteneder; Zuzana Diamant; Thomas Eiwegger; Wytske J Fokkens; Claudia Traidl-Hoffmann; Kari Nadeau; Robyn E O'Hehir; Liam O'Mahony; Oliver Pfaar; Maria J Torres; De Yun Wang; Luo Zhang; Cezmi A Akdis Journal: Allergy Date: 2019-06-04 Impact factor: 13.146