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Review
. 2023 Mar 22:11:1092578.
doi: 10.3389/fped.2023.1092578. eCollection 2023.

Clinical practice guidelines for neonatal hypoxic-ischemic encephalopathy: A systematic review using the appraisal of guidelines for research and evaluation (AGREE) II instrument

Yasser S Amer  1   2   3   4   5 , Jasim Anabrees  6   7 , Mohamed Abdelmawla  8 , Ayman Abdalgader  9 , Asmaa Almazroei  8 , Ibrahim Alhifzi  10 , Abdullah Hawash AlOnazi  11 , Yasser Sabr  12 , Layal Hneiny  13 , Ahmed El-Malky  14   15 , Ayesha Alshalawi  16 , Ahmed Alayoubi  17 , Iftikhar A Chaudhry  18 , Omar Elkhateeb  11
Affiliations
Review

Clinical practice guidelines for neonatal hypoxic-ischemic encephalopathy: A systematic review using the appraisal of guidelines for research and evaluation (AGREE) II instrument

Yasser S Amer et al. Front Pediatr. .

Abstract

Background and objective: To systematically review, critically appraise the quality of recent clinical practice guidelines (CPGs) for neonatal hypoxic ischemic encephalopathy (HIE), and map their recommendations.

Data sources: CPG databases (GIN, ECRI, NICE, SIGN, DynaMed), Bibliographic databases (PubMed, Embase, CINAHL), and related specialized professional societies (e.g., AAP, CPS, BAPM, RCPCH, and SNS).

Study selection: Original de-novo developed evidence-based CPGs for HIE, group authorship, Arabic or English languages, and international or national scope. The systematic review was drafted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and Johnston et al methodological guide.

Data extraction: Quality assessment of the included HIE CPGs by the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) Instrument and report their characteristics, AGREE II ratings, and recommendations.

Data synthesis: Our search retrieved 2,489 citations, of which two recent HIE CPGs were eligible and appraised: Canadian Paediatric Society (CPS) and Queensland Maternity and Neonatal Services (QMN). The overall assessment of the QMN CPG was superior (83%). Domain 1 (Scope & Purpose) scored (47%, 63%), Domain 2 (Stakeholder Involvement) (72%, 39%), Domain 3 (Rigour of Development) (48%, 43%), Domain 4 (Clarity & Presentation) (100%, 96%), Domain 5 (Applicability) (59%, 9%), and Domain 6 (Editorial Independence) (67%, 17%) for the QMN and CPS CPGs respectively. All appraisers recommended the QMN CPG for use in practice.

Conclusion: The methodological quality of the QMN CPG was superior with the relevant recommendations for its use in neonatal practice.

Limitations: limited to Arabic and English languages.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258291, identifier: CRD42021258291.

Keywords: AGREE II instrument; HIE; clinical practice guidelines; hypoxic ischemic encephalopathy; neonatology; pediatrics; quality assessment; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers, and other sources.
Figure 2
Figure 2
HIE CPGs/AGREE II domains: standardized Items’ scores.
Figure 3
Figure 3
Showed percent agreement among raters for the two HIE practice guidelines focusing on every question in every domain.
See this image and copyright information in PMC

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