ArticleJournal of general internal medicine2008
Rigorous development does not ensure that guidelines are acceptable to a panel of knowledgeable providers.
Article in Journal of general internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Dry mouth in palliative care: A systematic review of clinical practice guidelines around the world.Palliative medicine · 2026Pooled it
- Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.Annals of internal medicine · 2014Pooled it
- Pooled it
- Clinical practice guidelines to inform evidence-based clinical practice.World journal of urology · 2011Pooled it
- Machine learning models for predicting treatment outcomes in chronic non-specific back pain patients undergoing lumbar extension traction.Scientific reports · 2026Article
- An external peer review instrument for Korean Medicine clinical practice guideline drafts (KM-EPRI): development and content validation.Frontiers in medicine · 2026Article
- Long-term stability of reducing cervical kyphosis via Chiropractic BiophysicsJournal of physical therapy science · 2026Article
- Moving toward the Development and Effective Implementation of High-Quality Guidelines in Pediatric Surgery: A Review of the Literature.European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie · 2024Review
- Article
- Article
- Structural rehabilitation of the cervical lordosis and forward head posture: a selective review of Chiropractic BioPhysicsJournal of physical therapy science · 2022Review
- Quality of pediatric clinical practice guidelines.BMC pediatrics · 2021Article
- Assessment of the quality of recommendations from 161 clinical practice guidelines using the Appraisal of Guidelines for Research and Evaluation-Recommendations Excellence (AGREE-REX) instrument shows there is room for improvement.Implementation science : IS · 2020Article
- Development and Validation of a Tool to Assess the Quality of Clinical Practice Guideline Recommendations.JAMA network open · 2020Article
- The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis.BMC health services research · 2019Article
- Is it time to develop AGREE III?CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019Article
- Article
- Article
- How can we improve guideline use? A conceptual framework of implementability.Implementation science : IS · 2011Article
- AGREE II: advancing guideline development, reporting and evaluation in health care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2010Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRigorous guideline development methods are designed to produce recommendations that are relevant to common clinical situations and consistent with evidence and expert understanding, thereby promoting guidelines' acceptability to providers. No studies have examined whether this technical quality consistently leads to acceptability.
objectiveTo examine the clinical acceptability of guidelines having excellent technical quality. DESIGN AND MEASUREMENTS: We selected guidelines covering several musculoskeletal disorders and meeting 5 basic technical quality criteria, then used the widely accepted AGREE Instrument to evaluate technical quality. Adapting an established modified Delphi method, we assembled a multidisciplinary panel of providers recommended by their specialty societies as leaders in the field. Panelists rated acceptability, including "perceived comprehensiveness" (perceived relevance to common clinical situations) and "perceived validity" (consistency with their understanding of existing evidence and opinions), for ten common condition/therapy pairs pertaining to Surgery, physical therapy, and chiropractic manipulation for lumbar spine, shoulder, and carpal tunnel disorders.
resultsFive guidelines met selection criteria. Their AGREE scores were generally high indicating excellent technical quality. However, panelists found 4 guidelines to be only moderately comprehensive and valid, and a fifth guideline to be invalid overall. Of the topics covered by each guideline, panelists rated 50% to 69% as "comprehensive" and 6% to 50% as "valid".
conclusionDespite very rigorous development methods compared with guidelines assessed in prior studies, experts felt that these guidelines omitted common clinical situations and contained much content of uncertain validity. Guideline acceptability should be independently and formally evaluated before dissemination.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.