Evaluation of the quality of Colombian Pediatrics Clinical Practice Guidelines
Main Article Content
Abstract
DOI: 10.1016/j.rcpe.2015.12.001
Introduction
One of the millennium milestones is aimed at ensuring the health of children in Colombia. The Instute for Technological Evaluation in Health (Instituto de Evaluación Tecnológica en Salud) has developed ten clinical practice guidelines that seek to unify clinical, diagnostic and treatment concepts of childhood illness. The clinical practice guidelines are systematically developing recommendations to assist decision making by health professionals and patients, constituting a link between research and clinical practice. The aim of this study was to assess the methodological quality of Colombian clinical practice guidelines in paediatrics and generate explicit recommendations on their use.
Methodology
The Appraisal of Guidelines Research and Evaluation (AGREE II) tool was used. Three independent reviewers assessed each domain and graded them on a standardised 0-100% scale. The level of agreement between raters was assessed using the intraclass correlation coefficient.
Results
Clinical practice guidelines cover a broad spectrum of childhood diseases. In general, they obtained scores between 74% and 98%, classified as moderate to high quality. The guidelines for leukaemia and congenital abnormalities obtained the highest score, and asthma the lowest. The agreement between raters was very good for most domains.
Conclusions
Our assessment shows that paediatric guidelines have a moderate to high quality and, therefore, they are recommended for use in clinical practice. Domains like rigour of the development and applicability should be improved
Downloads
Article Details
Creative Commons
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
You are free to:
Share - copy and redistribute the material in any medium or format.
Adapt - remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
• ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
• No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
References
2 World Health Organization. WHO EMRO | IMCI Strategy | Child health and development [Internet]. EMRO. 2015 [citado 3 de marzo de 2015]. Recuperado a partir de: http://www.emro.who.int/child-health/imci-strategy/imci-strategy.html
3 Guía Operativa para Implementación de AIEPI en EPS e IPS.pdf [Internet]. [citado 3 de marzo de 2015]. Recuperado a partir de: http://www.medellin.gov.co/irj/go/km/docs/wpccontent/Sites/Subportal%20del%20Ciudadano/Salud/Secciones/Programas%20y%20Proyectos/Documentos/2013/AIEPI/Anexos/GU%C3%8DA%20OPERATIVA%20PARA%20IMPLEMENTACI%C3%93N%20DE%20AIEPI%20EN%20EPS%20e%20IPS.pdf
4 Objetivos de Desarrollo del Milenio. Colombia 2014 [Internet]. [citado 3 de marzo de 2015]. Recuperado a partir de: http://www.undp.org/content/dam/undp/library/MDG/english/MDG%20Country%20Reports/Colombia/informeanualodm2014.pdf
5 Metas y Estrategias de Colombia para el Logro de los Objetivos de Desarrollo del Milenio - 2015 [Internet]. [citado 3 de marzo de 2015]. Recuperado a partir de: http://www.colombiaaprende.edu.co/html/familia/1597/articles-305252_compes091.pdf
6 Estadísticas Sanitarias Mundiales 2013 [Internet]. [citado 3 de marzo de 2015]. Recuperado a partir de: http://apps.who.int/iris/bitstream/10665/82218/1/9789243564586_spa.pdf?ua=1
7 Ministerio de Salud y Protección Social, Colciencias. MinSalud y Colciencias lanzan 25 Guías de Práctica Clínica [Internet]. Colciencias. 2013 [citado 25 de abril de 2014]. Recuperado a partir de: http://www.colciencias.gov.co/noticias/minsalud-y-colciencias-lanzan-25-gu-de-pr-ctica-cl-nica-martes-23-de-julio-de-2013.
8 Instituto de Evaluación Tecnológica en Salud. Quiénes Somos Informe de Gestión [Internet]. IETS. 2013 [citado 3 de marzo de 2015]. Recuperado a partir de: http://www.iets.org.co/quienes-somos/informe-de-gesti%C3%B3n
9 M.J. Field,K.N. Lohr
Clinical Practice Guidelines: Directions for a New Program. Institute of Medicine
National Academies Press, (1990)
10 Carlos Ochoa Diseño y evaluación de guías de práctica clínica [Internet]. 2007 [citado 3 de marzo de 2015]. Recuperado a partir de: sabus.usal.es/bib_virtual/doc/carlos_ochoa_disenoeval_gpc.pdf.
11 P. Alonso-Coello,A. Irfan,I. Solà,I. Gich,M. Delgado-Noguera,D. Rigau
The quality of clinical practice guidelines over the last two decades: a systematic review of guideline appraisal studies
Qual Saf Health Care., 19 (2010), pp. 1-7
12 Lozano JM, Cuervo LG. Desarrollo de guías de práctica clínica basadas en la evidencia. En: Investigación Clínica: Epidemiologia clínica aplicada Santa Fe de Bogotá: Centro Editorial Javeriano. 2001. p. 379-410.
13 L.M.R. Nandé
Algunos apuntes sobre guías de práctica clínica
Rev Cuba Cardiol Cir Cardiovasc., 16 (2011), pp. 311-317
14 J.P. Gisbert,P. Alonso-Coello,J.M. Piqué
¿Cómo localizar, elaborar, evaluar y utilizar guías de práctica clínica?
Gastroenterol Hepatol, 31 (2008), pp. 239-257
Medline
15 X. Bonfill,M. Marzo
Guías de práctica clínica: tenerlas, que sean de calidad y que salgan del armario
Med Clin Barc., 120 (2003), pp. 496-497
Medline
16 C. Pérez,R. Rico
Cómo evaluar una guía de práctica clínica
Guías Clínicas., 7 (2007), pp. 4
17 S.H. Woolf
Practice guidelines, a new reality in medicine. II. Methods of developing guidelines
Arch Intern Med., 152 (1992), pp. 946-952
Medline
18 M.C. Brouwers,M.E. Kho,G.P. Browman,J.S. Burgers,F. Cluzeau,G. Feder
AGREE II: advancing guideline development, reporting and evaluation in health care
Can Med Assoc J., 182 (2010), pp. E839-E842
19 Task Force on Medical Management Guidelines
Guiding principles, attributes, and process to review medical management guidelines
Pediatrics., 108 (2001), pp. 1378-1382
Medline
20 J. Vlayen,B. Aertgeerts,K. Hannes,W. Sermeus,D. Ramaekers
A systematic review of appraisal tools for clinical practice guidelines: multiple similarities and one common deficit
Int J Qual Health Care., 17 (2005), pp. 235-242 http://dx.doi.org/10.1093/intqhc/mzi027
Medline
21 A.D. Oxman,H.J. Schünemann,A. Fretheim
Improving the use of research evidence in guideline development: 16. Evaluation
Health Res Policy Syst., 4 (2006), pp. 28 http://dx.doi.org/10.1186/1478-4505-4-28
Medline
22 R.B. Gutarra-Vilchez,L. Barajas-Nava,A. Aleman,I. Solà,I. Gich,X. Bonfill
Systematic evaluation of the quality of clinical practice guidelines on the use of assisted reproductive techniques
Hum Fertil Camb., 17 (2014), pp. 28-36 http://dx.doi.org/10.3109/14647273.2013.872301
Medline
23 L. Barajas-Nava,I. Solà,M. Delgado-Noguera,I. Gich,C.O. Villagran,X. Bonfill
Quality assessment of clinical practice guidelines in perioperative care: a systematic appraisal
Qual Saf Health Care., 19 (2010), pp. 1-8
Artículo
24 M. Delgado-Noguera,S. Tort,X. Bonfill,I. Gich,P. Alonso-Coello
Quality assessment of clinical practice guidelines for the prevention and treatment of childhood overweight and obesity
Eur J Pediatr., 168 (2009), pp. 789-799 http://dx.doi.org/10.1007/s00431-008-0836-5
Medline
25 L. Terrace
Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project
Qual Saf Health Care., 12 (2003), pp. 18-23
Medline
26 Association of the Scientific Medical Societies in Germany, Agency for Quality in Medicine. German Instrument for Methodological Guideline Appraisal - Deutsches Instrument zur methodischen Leitlinien-Bewertung (DELBI) [Internet]. 2005 [citado 10 de noviembre de 2015]. Recuperado a partir de: http://www.leitlinien.de/mdb/edocs/pdf/literatur/german-guideline-appraisal-instrument-delbi.pdf
27 J.M. Bland,D.G. Altman
Measurements error and correlation coefficients
BMJ., 312 (1996), pp. 1472-1473
Medline
28 Ministerio de Salud de Colombia. Resolución 008430 [Internet]. 1993 [citado 10 de noviembre de 2015]. Recuperado a partir de: https://www.unisabana.edu.co/fileadmin/Documentos/Investigacion/comite_de_etica/Res__8430_1993_-_Salud.pdf
29 J.D. Alarcon,A.M. Rubiano,M.S. Chirinos,A. Valderrama,I. Gich,X. Bonfill
Clinical practice guidelines for the care of patients with severe traumatic brain injury: A systematic evaluation of their quality
J Trauma Acute Care Surg., 75 (2013), pp. 311-319 http://dx.doi.org/10.1097/TA.0b013e3182924bf8
Artículo | Medline
30 G. Sanclemente,J-L. Acosta,M-E. Tamayo,X. Bonfill,P. Alonso-Coello
Clinical practice guidelines for treatment of acne vulgaris: a critical appraisal using the AGREE II instrument
Arch Dermatol Res., 306 (2014), pp. 269-277 http://dx.doi.org/10.1007/s00403-013-1394-x
Medline