ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025
Determining the methodological rigor and overall quality of out-of-hospital clinical practice guidelines: a scoping review.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Development of a GIN-McMaster Checklist Extension for Out-of-Hospital Health Guidelines: A Research Protocol.Clinical and public health guidelines · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOut-of-hospital clinical practice guidelines (CPGs) guide paramedics, emergency medical technicians and first responders, but their quality remains uncertain. This scoping review aims to identify, aggregate and describe all literature that has used a structured appraisal instrument to assess the methodological rigor and overall quality of out-of-hospital CPGs.
methodsThis study was conducted in accordance with the JBI methodology for scoping reviews and involved systematically searching the following databases and/or information sources with no publication or language limit applied: MEDLINE (Ovid), Embase (Elsevier), CINAHL with full text (EBSCO), Scopus (Elsevier), ProQuest Central (ProQuest).
resultsThis review identified 15 articles that appraised 311 unique out-of-hospital CPGs. These CPGs ranged in date of publication from 1998 to 2022. The majority of CPGs (267/311) were assessed using the Appraisal of Guidelines for Research & Evaluation (AGREE-II) instrument, with 146 guidelines appraised against two tools. Following aggregation, CPGs scored highest in Domain 4 (clarity of presentation) at 77.7% (SD = 15.1%), and lowest in Domain 5 (applicability) at 42.6% (SD = 23.7%). The average Domain 3 score (rigor of development) was 55.6% (SD = 25.7%). Of CPGs appraised against the AGREE-II instrument, 34.4% met our a priori definition of being high-quality (Domain 3 score of equal to or greater than 75%), while 31.3% were deemed medium-quality (Domain 3 score between 74% and 50%), and 34.3% were considered low-quality (Domain 3 score less than 50%). There were no significant changes observed in the average Domain 3 score over time (p = 0.092). 146 CPGs were assessed against the National Academy of Medicine criteria with 34.9% meeting all elements indicative of being a high-quality guideline, while 39 CPGs were assessed the 2016 National Health and Medical Research Council Standards for Guidelines with 0% meeting all criteria.
conclusionsOut-of-hospital CPGs currently have poor methodological rigor and are of medium to low overall quality. These results should be used to inform future research and initiatives that aim to standardize the methods used to develop guidelines used in this healthcare setting.
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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.