Meisser Madera1,2,3, Juan Franco4, Ivan Solà5,6, Xavier Bonfill5,6,7, Pablo Alonso-Coello5,6,7. 1. Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau, Barcelona, Spain. mmaderaa@unicartagena.edu.co. 2. Department of Research, Faculty of Dentistry, University of Cartagena, Campus de la Salud, Zaragocilla Cra. 50 # 29-11, CP, 130014, Cartagena, Colombia. mmaderaa@unicartagena.edu.co. 3. Public Health and Clinical Epidemiology Service, Sant Pau Hospital, Barcelona, Spain. mmaderaa@unicartagena.edu.co. 4. Cochrane Argentina, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina. 5. Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau, Barcelona, Spain. 6. Public Health and Clinical Epidemiology Service, Sant Pau Hospital, Barcelona, Spain. 7. CIBER of Epidemiology and Public Health, Barcelona, Spain.
Abstract
OBJECTIVES: To assess the quality of clinical practice guidelines (CPGs) on screening and diagnosis of oral cancer and to describe the characteristics of their recommendations. MATERIALS AND METHODS: We systematically searched EMBASE, MEDLINE, CPG' websites, and dentistry and oncology scientific societies to identify CPGs that were related to screening and diagnosis of oral cancer. The quality of selected CPGs was independently assessed by four appraisers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The inter-appraiser agreement was assessed. We performed a descriptive analysis of the recommendations included in the selected CPGs. RESULTS: Eight CPGs were selected. The overall agreement among reviewers was considered very good (ICC: 0.823; 95% CI: 0.777-0.861). The median scores of the six AGREE II domains were as follows: "scope and purpose" 97.9% (IQR: 96.2-100.0%); "stakeholder involvement" 86.1% (IQR: 69.8-93.1%); "rigor of development" 75.3% (IQR: 64.2-94.3%); "clarity of presentation" 91.7% (IQR: 82.6-94.4%); "applicability" 53.1% (IQR: 19.3-74.2%); and "editorial independence" 83.3% (IQR: 67.2-93.8%). Four CPGs were assessed as "recommended", four "recommended with modifications", and none "not recommended". Twenty-three recommendations were provided, mostly with a low or very low level of evidence. CONCLUSION: The methodological quality of CPGs on screening and diagnosis of oral cancer is moderate. The "applicability" domain scored the lowest. Most recommendations were based on a low o very low level of evidence. CLINICAL RELEVANCE: Greater efforts are needed to provide healthcare based on high-quality evidence-based CPGs in this field.
OBJECTIVES: To assess the quality of clinical practice guidelines (CPGs) on screening and diagnosis of oral cancer and to describe the characteristics of their recommendations. MATERIALS AND METHODS: We systematically searched EMBASE, MEDLINE, CPG' websites, and dentistry and oncology scientific societies to identify CPGs that were related to screening and diagnosis of oral cancer. The quality of selected CPGs was independently assessed by four appraisers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The inter-appraiser agreement was assessed. We performed a descriptive analysis of the recommendations included in the selected CPGs. RESULTS: Eight CPGs were selected. The overall agreement among reviewers was considered very good (ICC: 0.823; 95% CI: 0.777-0.861). The median scores of the six AGREE II domains were as follows: "scope and purpose" 97.9% (IQR: 96.2-100.0%); "stakeholder involvement" 86.1% (IQR: 69.8-93.1%); "rigor of development" 75.3% (IQR: 64.2-94.3%); "clarity of presentation" 91.7% (IQR: 82.6-94.4%); "applicability" 53.1% (IQR: 19.3-74.2%); and "editorial independence" 83.3% (IQR: 67.2-93.8%). Four CPGs were assessed as "recommended", four "recommended with modifications", and none "not recommended". Twenty-three recommendations were provided, mostly with a low or very low level of evidence. CONCLUSION: The methodological quality of CPGs on screening and diagnosis of oral cancer is moderate. The "applicability" domain scored the lowest. Most recommendations were based on a low o very low level of evidence. CLINICAL RELEVANCE: Greater efforts are needed to provide healthcare based on high-quality evidence-based CPGs in this field.
Authors: Marcella R Poelman; Henk S Brand; Laura Foppen; Jan G A M de Visscher; Derk H Jan Jager Journal: Eur J Dent Educ Date: 2021-05-24 Impact factor: 2.528