TY - JOUR
T1 - Nutrition in critically ill adults: A systematic quality assessment of clinical practice guidelines
AU - Fuentes Padilla, Paulina
AU - Martínez, Gabriel
AU - Vernooij, Robin W.M.
AU - Cosp, Xavier Bonfill
AU - Alonso-Coello, Pablo
PY - 2016/12/1
Y1 - 2016/12/1
N2 - © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background & aims Nutritional support in the acutely ill is a complex topic. Clinical practice guidelines (CPGs) have been developed to assist healthcare professionals working in this field. However, the quality of these clinical guidelines has not yet been systematically assessed. The objective of our study was to identify and assess the quality of CPGs on nutrition in critically ill adult patients. Methods We performed a systematic search to identify CPGs on nutrition in critically ill adult patients. Three independent appraisers assessed six domains (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) of the eligible CPGs using the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) instrument. Results Nine CPGs were selected. Overall agreement among appraisers was very good (ICC: 0.853; 95% CI: 0.820–0.881). The mean scores for each AGREE domain were the following: “scope and purpose” 76.2% ± 13.7%; “stakeholder involvement” 42.8% ± 16.5%; “rigour of development” 57.9% ± 18.1%; “clarity of presentation” 76.9% ± 13.7%; “applicability” 30.1% ± 22.8%; and 42.1% ± 23.9% for “editorial independence”. Four CPGs were deemed “Recommended”; three “Recommended with modifications”; and two “Not recommended”. We did not observe improvement over time in the overall quality of the CPGs. Conclusions The overall quality of CPGs on nutrition in critically ill adults is suboptimal, with only four CPGs being recommended for clinical use. Our results highlight the need to revise and improve CPG development processes in this field.
AB - © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background & aims Nutritional support in the acutely ill is a complex topic. Clinical practice guidelines (CPGs) have been developed to assist healthcare professionals working in this field. However, the quality of these clinical guidelines has not yet been systematically assessed. The objective of our study was to identify and assess the quality of CPGs on nutrition in critically ill adult patients. Methods We performed a systematic search to identify CPGs on nutrition in critically ill adult patients. Three independent appraisers assessed six domains (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) of the eligible CPGs using the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) instrument. Results Nine CPGs were selected. Overall agreement among appraisers was very good (ICC: 0.853; 95% CI: 0.820–0.881). The mean scores for each AGREE domain were the following: “scope and purpose” 76.2% ± 13.7%; “stakeholder involvement” 42.8% ± 16.5%; “rigour of development” 57.9% ± 18.1%; “clarity of presentation” 76.9% ± 13.7%; “applicability” 30.1% ± 22.8%; and 42.1% ± 23.9% for “editorial independence”. Four CPGs were deemed “Recommended”; three “Recommended with modifications”; and two “Not recommended”. We did not observe improvement over time in the overall quality of the CPGs. Conclusions The overall quality of CPGs on nutrition in critically ill adults is suboptimal, with only four CPGs being recommended for clinical use. Our results highlight the need to revise and improve CPG development processes in this field.
KW - AGREE instrument
KW - Clinical practice guidelines
KW - Critically ill
KW - Guidelines
KW - Nutrition therapy
KW - Quality assessment
U2 - 10.1016/j.clnu.2016.03.005
DO - 10.1016/j.clnu.2016.03.005
M3 - Review article
VL - 35
SP - 1219
EP - 1225
JO - Clinical Nutrition
JF - Clinical Nutrition
SN - 0261-5614
IS - 6
ER -