South African clinical practice guidelines quality measured with complex and rapid appraisal instruments
Date
2016-04-27
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
ENGLISH SUMMARY : Background: Critically appraising the quality of clinical practice guidelines (CPGs) is an essential element of evidence implementation. Critical appraisal considers the quality of CPG construction and reporting processes, and the credibility of the body of evidence underpinning ecommendations. To date, the focus on CPG critical appraisal has come from researchers and evaluators, using complex appraisal instruments. Rapid critical appraisal is a relatively new
approach for CPGs, which targets busy end-users such as service managers and clinicians. This paper compares the
findings of two critical appraisal instruments: a rapid instrument (iCAHE) and a complex instrument (AGREE II). They were applied independently to 16 purposively-sampled, heterogeneous South African CPGs, written for eleven primary health care conditions/health areas. Overall scores, and scores in the two instruments’ common domains Scope
and Purpose, Stakeholder involvement, Underlying evidence/Rigour of Development, Clarity), were compared using Pearson r correlations and intraclass correlation coefficients. CPGs with differences of 10 % or greater between scores were identified and reasons sought for such differences. The time taken to apply the instruments was recorded.
Results: Both instruments identified the generally poor quality of the included CPGs, particularly in Rigour of Development. Correlation and agreement between instrument scores was moderate, and there were no overall significant
score differences. Large differences in scores for some CPGs could be explained by differences in instrument construction
and focus, and CPG construction. The iCAHE instrument was demonstrably quicker to use than the AGREE II
instrument.
Conclusions: Either instrument could be used with confidence to assess the quality of CPGs. The choice of appraisal
instrument depends on the needs and time of end-users. Having an alternative (rapid) critical appraisal tool will
potentially encourage busy end-users to identify and use good quality CPGs to inform practice decisions.
Description
CITATION: Grimmer, K., et al. 2016. South African clinical practice guidelines quality measured with complex and rapid
appraisal instruments. BMC Research Notes, 9:244, doi:10.1186/s13104-016-2053-z.
The original publication is available at http://bmcresnotes.biomedcentral.com
The original publication is available at http://bmcresnotes.biomedcentral.com
Keywords
Medical protocols -- South Africa, Clinical medicine -- Practice
Citation
Grimmer, K., et al. 2016. South African clinical practice guidelines quality measured with complex and rapid appraisal instruments. BMC Research Notes, 9:244, doi:10.1186/s13104-016-2053-z.