Methodological and reporting quality of pediatric clinical practice guidelines: a systematic review
Bibliographic record
Abstract
BACKGROUND: Pediatric clinical practice guidelines (CPGs) can provide systematically developed clinical recommendations to guide pediatric clinicians and patients making decisions. This study aims to assess the methodological and reporting quality of pediatric CPGs. METHODS: We performed a systematic literature search of MEDLINE from 1 January 1990 to 2 April 2020 to identify pediatric CPGs published in the ten highest-impact pediatric journals and four highest-impact general medical journals. Two researchers evaluated the methodological and reporting quality of pediatric CPGs using the Appraisal of Guidelines Research and Evaluation (AGREE) II instrument and Reporting Items for Practice Guidelines in Health care (RIGHT) checklist. We calculated the mean AGREE II scores and compliance to RIGHT overall, and for each domain of the respective tools. We compared the methodological and reporting quality by different time periods and calculated the correlation between the AGREE II score and compliance to RIGHT. RESULTS: A total of 159 pediatric CPGs were identified. The mean (± standard deviation) scores for the six domains of the AGREE II instrument were as follows: scope and purpose 74.5%±14.2%, stakeholder involvement 42.7%±16.2%, rigour of development 18.7%±14.2%, clarity of presentation 56.5%±17.0%, applicability 8.9%±12.7% and editorial independence 25.2%±34.6%. The overall assessment score was 37.8%±12.4%. The mean compliance to RIGHT items in the seven domains of the checklist were: basic information 73.6%±14.9%, background 67.1%±16.4%, evidence 32.7%±27.2%, recommendations 32.4%±22.5%, review and quality assurance 22.9%±40.4%, funding and declaration and management of interests 24.1%±36.3%, and other information 45.3%±30.1%. The overall reporting rate for RIGHT was 46.4%±16.6%. Both the AGREE II scores and RIGHT reporting rates increased over time. We found a high positive correlation between AGREE II scores and RIGHT reporting compliance (r=0.645, P<0.001). DISCUSSION: The methodological and reporting quality of pediatric CPGs have improved over time, but remain still suboptimal and needs to be further improved. An international database of pediatric guidelines is urgently needed to identify and promote high-quality guidelines and guide clinical practice in pediatrics.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.328 | 0.727 |
| Meta-epidemiology (narrow) | 0.002 | 0.003 |
| Meta-epidemiology (broad) | 0.009 | 0.010 |
| Bibliometrics | 0.022 | 0.025 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".