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Nonconformity in the Clinical Practice Guidelines for Subclinical Cushing's Syndrome: Which Guidelines Are Trustworthy?
MedLine Citation:
PMID:  24986532     Owner:  NLM     Status:  Publisher    
Objective: This study aimed to systematically evaluate the quality of clinical practice guidelines (CPGs) and to compare their recommendations for managing subclinical Cushing's syndrome (SCS) to assist practitioners in making rapid clinical decisions. Design and methods: SCS management guidelines were retrieved from electronic databases. The Appraisal of Guidelines Research and Evaluation II (AGREE-II) tool and the Institute of Medicine (IOM) criteria were used to evaluate the quality of the selected guidelines. In addition, we further compared recommendations, cited references, and levels of evidence between the SCS management guidelines. Results: We included five guidelines that were obtained through the literature selection process. Based on the AGREE-II and IOM criteria, none of the selected guidelines was satisfactory in all aspects. However, the Italian Association of Clinical Endocrinologists (IACE) guidelines demonstrated slightly higher scores than did the other guidelines, so this guideline was recommended (with certain modifications for several domains). Regarding the content of the CPGs, we found considerable differences in the recommendations for managing SCS. These differences were derived from citation selection bias, evidence interpretation bias, differences in the composition of the guidelines' workgroups, and the omission of guidelines for updating and externally reviewing the recommendations. Conclusions: There is generally poor guideline quality among different organisations, and remarkable differences exist in the recommendations for the same clinical subject. Therefore, future guideline development should be performed in strict accordance with the AGREE-II and IOM criteria. Keywords: clinical practice guidelines, comparison, subclinical Cushing's syndrome, AGREE-II, IOM.
Jing Shen; Mingfang Sun; Bo Zhou; Juping Yan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-1
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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