Evidence map›Paper›PMID 20217048›Full record

ReviewIntensive care medicine2010

A critical appraisal of the quality of critical care pharmacotherapy clinical practice guidelines and their strength of recommendations.

Sean K Gorman, Michelle Ho Chung, Richard S Slavik, Peter J Zed, Kerry Wilbur, Vinay K Dhingra

Erratum issuedAbstract readReviewValidation Study
PubMed Publisher
In one paragraph

Review in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
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4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

6 authors.

Sean K GormanDepartment of Pharmacy, Capital District Health Authority, College of Pharmacy, Dalhousie University, c/o Rm 2043 Victoria Building, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada. sean.gorman@dal.ca.
Michelle Ho ChungDepartment of Pharmacy, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Richard S SlavikPharmacy Department, Interior Health Authority, Faculty of Pharmaceutical Sciences, University of British Columbia, 200-1835 Gordon Drive, Kelowna, BC, V1Y 3H5, Canada.
Peter J ZedDepartment of Pharmacy, Capital District Health Authority, College of Pharmacy, Dalhousie University, c/o Rm 2043 Victoria Building, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada.
Kerry WilburCollege of Pharmacy, Qatar University, P.O. Box 2713, Doha, Qatar.
Vinay K DhingraIntensive Care Unit, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveClinical practice guideline (CPG) quality assessment is important before applying their recommendations. Determining whether recommendation strength is consistent with supporting quality of evidence is also essential. We aimed to determine quality of critical care pharmacotherapy CPGs and to assess whether high quality evidence supports strong pharmacotherapy recommendations.

methodsMEDLINE (1966-February 2008), EMBASE (1980-February 2008), National Guideline Clearinghouse (February 2008) and personal files were searched to identify CPGs. Four appraisers evaluated each guideline using the appraisal of guidelines, research and evaluation (AGREE) instrument. AGREE assesses 23 items in six domains that include scope/purpose, stakeholder involvement, rigor of development, clarity, applicability and editorial independence. Standardized domain scores (0-100%) were determined to decide whether to recommend a guideline for use. One appraiser extracted strong pharmacotherapy recommendations and supporting evidence quality.

resultsTwenty-four CPGs were included. Standardized domain scores were clarity [69% (95% confidence interval (CI) 62-76%)], scope/purpose [62% (95% CI 55-68%)], rigor of development [51% (95% CI 42-60%)], editorial independence [39% (95% CI 26-52%)], stakeholder involvement [32% (95% CI 26-37%)] and applicability [19% (95% CI 12-26%)]. The proportion of guidelines that could be strongly recommended, recommended with alterations and not recommended was 25, 37.5 and 37.5%, respectively. High quality evidence supported 36% of strong pharmacotherapy recommendations.

conclusionVariation in AGREE domain scores explain why one-third of critical care pharmacotherapy CPGs cannot be recommended. Only one-third of strong pharmacotherapy recommendations were supported by high quality evidence. We recommend appraisal of guideline quality and the caliber of supporting evidence prior to applying recommendations.

Indexed as

Practice Guidelines as TopicCritical CareDrug TherapyHumans

Identifiers

PMID20217048

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.