Evaluation of the quality of published SCI clinical practice guidelines using the AGREE II instrument: Results from Can-SCIP expert panel

The Journal of Spinal Cord Medicine, 2021 · DOI: 10.1080/10790268.2021.1961053 · Published: January 1, 2021

Spinal Cord Injury Healthcare Research Methodology & Design

Simple Explanation

Spinal cord injury (SCI) is a complex condition needing evidence-based care. This study evaluates the quality of SCI clinical practice guidelines (CPGs). The study assessed the development process and methodological rigor of published SCI CPGs. It covered care from pre-hospital to community-based settings. The AGREE II instrument was used to evaluate the CPGs. This tool assesses various aspects of guideline quality.

Study Duration

Not specified

Participants

41 CPGs

Evidence Level

Not specified

Key Findings

1
The study found high variability in the quality of the CPGs. Twenty-seven CPGs achieved a good rigour of development domain score of >70%.
2
Standardized mean domain scores varied: scope and purpose (85.32%), stakeholder involvement (65.03%), clarity of presentation (84.81%), applicability (55.55%) and editorial independence (75.83%).
3
There is a paucity of CPGs that address community-based specialized rehabilitation and community reintegration.

Research Summary

This study evaluated the quality of published clinical practice guidelines (CPGs) for spinal cord injury (SCI) using the AGREE II instrument, covering the care continuum from pre-hospital to community-based care. The assessment of forty-one CPGs revealed high variability in quality, with 'rigour of development' scores showing that 65% of CPGs achieved a score over 70%. The study identified gaps in CPGs addressing community-based specialized rehabilitation and the need for comprehensive, interprofessional care guidelines for SCI management across the lifespan.

Practical Implications

Guideline Development

Future guideline development should focus on rigorous methodologies, stakeholder involvement, and applicability.

Addressing Gaps

Address the lack of CPGs for community-based specialized rehabilitation and community reintegration.

Comprehensive Care

Develop comprehensive, interprofessional care guidelines for SCI management across the lifespan.

Study Limitations

1
The AGREE instrument does not provide benchmark cutoff values, and the values selected in this study (benchmark of 40%) were selected by the Can-SCIP steering committee.
2
The inclusion of only CPGs in English may have excluded high-quality CPGs.
3
CPGs that are published within large peer-reviewed journals may not have disclosed all methodology because of page and word limitations

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