Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 5;22(1):447.
doi: 10.1186/s12876-022-02539-9.

Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review

R Zambrano-Sánchez  1 , P Alvarez-Mena  1 , D Hidalgo  2 , C M Escobar Liquitay  3 , J V A Franco  4 , R W M Vernooij  5 , D Simancas-Racines  6 , A Viteri-García  6 , C Montesinos-Guevara  7
Affiliations

Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review

R Zambrano-Sánchez et al. BMC Gastroenterol. .

Abstract

Background: The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their methodological quality. Therefore, we aimed to systematically evaluate the quality of CPGs for the diagnosis and treatment of IBD using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.

Methods: We identified CPGs by searching databases (MEDLINE - PubMed, EMBASE, CINAHL, LILACS) and other sources of gray literature on January 2022. We included guidelines with specific recommendations for the diagnosis and treatment of IBD and evaluated them with the AGREE II instrument to assess their methodological quality. Six independent reviewers assessed the quality of the guidelines and resolved conflicts by consensus. We assessed the degree of agreement using the intraclass correlation coefficient (ICC) and change in quality over time was appraised in two periods: from 2012 to 2017 and from 2018 to 2022.

Results: We analyzed and evaluated 26 CPGs that met the inclusion criteria. The overall agreement among reviewers was moderate (ICC: 0.74; 95% CI 0.36 - 0.89). The mean scores of the AGREE II domains were: "Scope and purpose" 84.51%, "Stakeholder involvement" 60.90%, "Rigor of development" 69.95%, "Clarity of presentation" 85.58%, "Applicability" 26.60%, and "Editorial independence" 62.02%. No changes in quality were found over time.

Conclusions: The quality of the CPGs evaluated was generally good, with a large majority of the assessed guidelines being "recommended" and "recommended with modifications"; despite this, there is still room for improvement, especially in terms of stakeholder involvement and applicability. Efforts to develop high quality CPGs for IBD need to be further optimized.

Keywords: Clinical practice guidelines; Crohn disease; Inflammatory bowel disease; Systematic review; Ulcerative colitis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
PRISMA flow diagram showing the flow of records that were obtained and reviewed throughout the different phases of the quality assessment
Fig. 2
Fig. 2
Distribution of standardized scores by domain for the 26 CPGs
Fig. 3
Fig. 3
Radar chart of the mean standardized scores by domains of the 26 IBD CPGs assessed
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Disponible en. 2019;68(3):1–106. doi: 10.1136/gutjnl-2019-318484. - DOI - PMC - PubMed
    1. Yamamoto-Furushoa K, Bosques-Padilla B, de-Paula J, Galiano MT, P. Ibañez P, Juliao F, et al. Diagnosis and treatment of inflammatory bowel disease: First Latin American Consensus of the Pan American Crohn's sand Colitis Organisation. Rev Mex Med. 2017;82(1):46–84. doi: 10.1016/j.rgmx.2016.07.003. - DOI - PubMed
    1. Turpin W, Goethel A, Bedrani L, Croitoru K. Determinants of IBD Heritability: Genes, Bugs, and More. Inflamm Bowel Dis. 2018;24(6):1133–1148. doi: 10.1093/ibd/izy085. - DOI - PMC - PubMed
    1. Ahluwalia B, Moraes L, Magnusson MK, Öhman L. Immunopathogenesis of inflammatory bowel disease and mechanisms of biological therapies. Scand J Gastroenterol. 2018;53(4):379–389. doi: 10.1080/00365521.2018.1447597. - DOI - PubMed
    1. Glassner KL, Abraham BP. Current perspectives The microbiome and inflammatory bowel disease. J Allergy Clin Immunol. 2019;145(1):16–27. doi: 10.1016/j.jaci.2019.11.003. - DOI - PubMed

Publication types

LinkOut - more resources