TY - JOUR
T1 - Systematic review of diabetic eye disease practice guidelines
T2 - more applicability, transparency and development rigor are needed
AU - Gyawali, Rajendra
AU - Toomey, Melinda
AU - Stapleton, Fiona
AU - Zangerl, Barbara
AU - Dillon, Lisa
AU - Ho, Kam Chun
AU - Keay, Lisa
AU - Alkhawajah, Sally Marwan M.
AU - Liew, Gerald
AU - Jalbert, Isabelle
N1 - Funding Information:
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Objectives: To assess the quality of diabetic eye disease clinical practice guidelines. Study design and setting: A systematic search of diabetic eye disease guidelines was conducted on six online databases and guideline repositories. Four reviewers independently rated quality using the Appraisal of Guidelines, Research, and Evaluation (AGREE II) instrument. Aggregate scores (%) for six domains and overall quality assessment were calculated. A “good quality” guideline was one with ≥60% score for “rigor of development” and in at least two other domains. Results: Eighteen guidelines met the inclusion criteria, of which 13 were evidence-based guidelines (involved systematic search and grading of evidence). The median scores (interquartile range (IQR)) for “scope and purpose,” “stakeholder involvement,” “rigor of development,” “clarity of presentation,” “applicability” and “editorial independence” were 73.6% (54.2%–80.6%), 48.6% (29.2%–71.5%), 60.2% (30.9%–78.1%), 86.6% (76.7%–94.4%), 28.6% (18.0%–37.8%) and 60.2% (30.9%–78.1%), respectively. The median overall score (out of 7) of all guidelines was 5.1 (IQR: 3.7–5.8). Evidence-based guidelines scored significantly higher compared to expert-consensus guidelines. Half (n = 9) of the guidelines (all evidence-based) were of “good quality.” Conclusion: A wide variation in methodological quality exists among diabetic eyecare guidelines, with nine demonstrating “good quality.” Future iterations of guidelines could improve by appropriately engaging stakeholders, following a rigorous development process, including support for application in clinical practice and ensuring editorial transparency.
AB - Objectives: To assess the quality of diabetic eye disease clinical practice guidelines. Study design and setting: A systematic search of diabetic eye disease guidelines was conducted on six online databases and guideline repositories. Four reviewers independently rated quality using the Appraisal of Guidelines, Research, and Evaluation (AGREE II) instrument. Aggregate scores (%) for six domains and overall quality assessment were calculated. A “good quality” guideline was one with ≥60% score for “rigor of development” and in at least two other domains. Results: Eighteen guidelines met the inclusion criteria, of which 13 were evidence-based guidelines (involved systematic search and grading of evidence). The median scores (interquartile range (IQR)) for “scope and purpose,” “stakeholder involvement,” “rigor of development,” “clarity of presentation,” “applicability” and “editorial independence” were 73.6% (54.2%–80.6%), 48.6% (29.2%–71.5%), 60.2% (30.9%–78.1%), 86.6% (76.7%–94.4%), 28.6% (18.0%–37.8%) and 60.2% (30.9%–78.1%), respectively. The median overall score (out of 7) of all guidelines was 5.1 (IQR: 3.7–5.8). Evidence-based guidelines scored significantly higher compared to expert-consensus guidelines. Half (n = 9) of the guidelines (all evidence-based) were of “good quality.” Conclusion: A wide variation in methodological quality exists among diabetic eyecare guidelines, with nine demonstrating “good quality.” Future iterations of guidelines could improve by appropriately engaging stakeholders, following a rigorous development process, including support for application in clinical practice and ensuring editorial transparency.
KW - AGREE II
KW - Clinical practice guidelines
KW - Diabetic eye disease
KW - Diabetic retinopathy
KW - Quality
UR - http://www.scopus.com/inward/record.url?scp=85115995982&partnerID=8YFLogxK
U2 - 10.1016/j.jclinepi.2021.08.031
DO - 10.1016/j.jclinepi.2021.08.031
M3 - Article
C2 - 34487836
AN - SCOPUS:85115995982
SN - 0895-4356
VL - 140
SP - 56
EP - 68
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -