Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://repositorio.unifesp.br/handle/11600/56710 http://dx.doi.org/10.1371/journal.pone.0166367 |
Resumo: | Background Annually, non-communicable diseases (NCDs) kill 38 million people worldwide, with low and middle-income countries accounting for three-quarters of these deaths. High-quality clinical practice guidelines (CPGs) are fundamental to improving NCD management. The present study evaluated the methodological rigor and transparency of Brazilian CPGs that recommend pharmacological treatment for the most prevalent NCDs. Methods We conducted a systematic search for CPGs of the following NCDs: asthma, atrial fibrillation, benign prostatic hyperplasia, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and/or stable angina, dementia, depression, diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, osteoarthritis, and osteoporosis. CPGs comprising pharmacological treatment recommendations were included. No language or year restrictions were applied. CPGs were excluded if they were merely for local use and referred to NCDs not listed above. CPG quality was independently assessed by two reviewers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II). Main Findings "Scope and purpose" and "clarity and presentation" domains received the highest scores. Sixteen of 26 CPGs were classified as low quality, and none were classified as high overall quality. No CPG was recommended without modification (77% were not recommended at all). After 2009, 2 domain scores ("rigor of development" and "clarity and presentation") increased (61% and 73%, respectively). However, "rigor of development" was still rated <30%. Conclusion Brazilian healthcare professionals should be concerned with CPG quality for the treatment of selected NCDs. Features that undermined AGREE II scores included the lack of a multidisciplinary team for the development group, no consideration of patients' preferences, insufficient information regarding literature searches, lack of selection criteria, formulating recommendations, authors' conflict of interest disclosures, and funding body influence. |
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Rezende Costa Molino, Caroline de GodoiRomano-Lieber, Nicolina SilvanaRibeiro, ElianeMelo, Daniela Oliveira de [UNIFESP]2020-07-31T12:47:16Z2020-07-31T12:47:16Z2016Plos One. San Francisco, v. 11, n. 11, p. -, 2016.1932-6203https://repositorio.unifesp.br/handle/11600/56710http://dx.doi.org/10.1371/journal.pone.0166367WOS000387794600052.pdf10.1371/journal.pone.0166367WOS:000387794600052Background Annually, non-communicable diseases (NCDs) kill 38 million people worldwide, with low and middle-income countries accounting for three-quarters of these deaths. High-quality clinical practice guidelines (CPGs) are fundamental to improving NCD management. The present study evaluated the methodological rigor and transparency of Brazilian CPGs that recommend pharmacological treatment for the most prevalent NCDs. Methods We conducted a systematic search for CPGs of the following NCDs: asthma, atrial fibrillation, benign prostatic hyperplasia, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and/or stable angina, dementia, depression, diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, osteoarthritis, and osteoporosis. CPGs comprising pharmacological treatment recommendations were included. No language or year restrictions were applied. CPGs were excluded if they were merely for local use and referred to NCDs not listed above. CPG quality was independently assessed by two reviewers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II). Main Findings "Scope and purpose" and "clarity and presentation" domains received the highest scores. Sixteen of 26 CPGs were classified as low quality, and none were classified as high overall quality. No CPG was recommended without modification (77% were not recommended at all). After 2009, 2 domain scores ("rigor of development" and "clarity and presentation") increased (61% and 73%, respectively). However, "rigor of development" was still rated <30%. Conclusion Brazilian healthcare professionals should be concerned with CPG quality for the treatment of selected NCDs. Features that undermined AGREE II scores included the lack of a multidisciplinary team for the development group, no consideration of patients' preferences, insufficient information regarding literature searches, lack of selection criteria, formulating recommendations, authors' conflict of interest disclosures, and funding body influence.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Univ Sao Paulo, Fac Pharmaceut Sci, Dept Pharm, Sao Paulo, BrazilUniv Sao Paulo, Sch Publ Hlth, Dept Publ Hlth Practice, Sao Paulo, BrazilUniv Sao Paulo, Fac Pharmaceut Sci, Dept Pharm, Univ Sao Paulo Hosp, Sao Paulo, BrazilUniv Fed Sao Paulo, Inst Environm Sci Chem & Pharmaceut, Dept Biol Sci, Sao Paulo, BrazilDepartment of Biological Sciences, Institute of Environmental Sciences, Chemical and Pharmaceutical, Universidade Federal de São Paulo (UNIFESP), Diadema, São Paulo, BrazilCNPq: 164700/2015-3Web of Science-engPublic Library SciencePlos OneNon-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparencyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleSan Francisco1111info:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000387794600052.pdfapplication/pdf1206338${dspace.ui.url}/bitstream/11600/56710/1/WOS000387794600052.pdfcf1f16850ab03029e56f82c30734d2e6MD51open accessTEXTWOS000387794600052.pdf.txtWOS000387794600052.pdf.txtExtracted texttext/plain48333${dspace.ui.url}/bitstream/11600/56710/8/WOS000387794600052.pdf.txt2be6bc6befa0120785c8b35baa4985bcMD58open accessTHUMBNAILWOS000387794600052.pdf.jpgWOS000387794600052.pdf.jpgIM Thumbnailimage/jpeg7472${dspace.ui.url}/bitstream/11600/56710/10/WOS000387794600052.pdf.jpge810760e1c152165917d72b98b3d95ecMD510open access11600/567102023-06-05 19:27:43.468open accessoai:repositorio.unifesp.br:11600/56710Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-06-05T22:27:43Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency |
title |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency |
spellingShingle |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency Rezende Costa Molino, Caroline de Godoi |
title_short |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency |
title_full |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency |
title_fullStr |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency |
title_full_unstemmed |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency |
title_sort |
Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency |
author |
Rezende Costa Molino, Caroline de Godoi |
author_facet |
Rezende Costa Molino, Caroline de Godoi Romano-Lieber, Nicolina Silvana Ribeiro, Eliane Melo, Daniela Oliveira de [UNIFESP] |
author_role |
author |
author2 |
Romano-Lieber, Nicolina Silvana Ribeiro, Eliane Melo, Daniela Oliveira de [UNIFESP] |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Rezende Costa Molino, Caroline de Godoi Romano-Lieber, Nicolina Silvana Ribeiro, Eliane Melo, Daniela Oliveira de [UNIFESP] |
description |
Background Annually, non-communicable diseases (NCDs) kill 38 million people worldwide, with low and middle-income countries accounting for three-quarters of these deaths. High-quality clinical practice guidelines (CPGs) are fundamental to improving NCD management. The present study evaluated the methodological rigor and transparency of Brazilian CPGs that recommend pharmacological treatment for the most prevalent NCDs. Methods We conducted a systematic search for CPGs of the following NCDs: asthma, atrial fibrillation, benign prostatic hyperplasia, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and/or stable angina, dementia, depression, diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, osteoarthritis, and osteoporosis. CPGs comprising pharmacological treatment recommendations were included. No language or year restrictions were applied. CPGs were excluded if they were merely for local use and referred to NCDs not listed above. CPG quality was independently assessed by two reviewers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II). Main Findings "Scope and purpose" and "clarity and presentation" domains received the highest scores. Sixteen of 26 CPGs were classified as low quality, and none were classified as high overall quality. No CPG was recommended without modification (77% were not recommended at all). After 2009, 2 domain scores ("rigor of development" and "clarity and presentation") increased (61% and 73%, respectively). However, "rigor of development" was still rated <30%. Conclusion Brazilian healthcare professionals should be concerned with CPG quality for the treatment of selected NCDs. Features that undermined AGREE II scores included the lack of a multidisciplinary team for the development group, no consideration of patients' preferences, insufficient information regarding literature searches, lack of selection criteria, formulating recommendations, authors' conflict of interest disclosures, and funding body influence. |
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2016 |
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