TY - JOUR
T1 - Alcohol use disorder
T2 - An analysis of the evidence underpinning clinical practice guidelines
AU - Tanner, David
AU - Minley, Kirstien
AU - Snider, Kelsey
AU - Hartwell, Micah
AU - Torgerson, Trevor
AU - Ottwell, Ryan
AU - Beaman, Jason
AU - Vassar, Matt
N1 - Funding Information:
Research reported in this publication was supported by the National Institute On Alcohol Abuse And Alcoholism of the National Institutes of Health under Award Number T35AA028204 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Dr. Vassar reports receipt of funding from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the US Office of Research Integrity, Oklahoma Center for Advancement of Science and Technology, and internal grants from Oklahoma State University Center for Health Sciences — all outside of the present work. Dr. Hartwell reports receiving funding from the National Institutes of Justice unrelated to the present work.
Funding Information:
The pre-registration of SR protocols provides accountability for selective reporting, promotes collaboration between investigators, and optimizes research efforts by reducing duplicate study designs. ( Shamseer et al., 2015 ) Several platforms exist for SR protocol registration, including PROSPERO funded by the National Institute of Health Research (NIHR). PROSPERO is an established platform endorsed by PRISMA that permanently stores SR protocols across research fields relevant to healthcare ( PROSPERO, 24.21 ). Protocol registration increases transparency and instills confidence in the outcomes reported by SRs. Moreover, established protocols should contain a predefined risk of bias assessment, another area we found to be deficient among SRs. Therefore, we recommend that authors of systematic reviews pre-register their studies and that publishing journals of systematic reviews consider pre-registration a requirement to author guidelines.
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background: As Clinical Practice Guidelines (CPGs) provide effective guidance for providing medical care for individuals with alcohol use disorder (AUD), the evidence behind them should be robust. Objective: Our primary objective was to critically appraise the methodological and reporting quality of systematic reviews cited within CPGs regarding the treatment of AUD. Our secondary objective was to determine how frequently Cochrane Reviews were cited as justification and to evaluate appraisals between Cochrane and non-Cochrane reviews. Methods: We searched PubMed to identify CPGs for the treatment of AUD published between 2015 and 2021. Systematic reviews included in each CPG were evaluated using the Preferred Reporting Instrument for Systematic Reviews and Meta-Analyses (PRISMA) and a validated quality assessment tool (AMSTAR-2). Additional study characteristics were recorded. Results: From the screening process, 98 systematic reviews from 6 CPGs met inclusion criteria. PRISMA adherence ranged from 72% to 85% (mean of 79%). AMSTAR-2 adherence ranged from 52% to 73% (mean of 68%). AMSTAR appraisal ratings found 32 (35.6%) critically low, 10 (11.1%) low, 35 (38.9%) moderate, and only 13 (14.4%) high systematic reviews. Cochrane systematic reviews displayed greater PRISMA (0.92 vs. 0.75: p < 0.001) and AMSTAR-2 (0.90 vs. 0.61.; p < 0.001) scores compared to the non-Cochrane studies. Conclusion: Systematic reviews included in CPGs for AUD treatment showed variable adherence to PRISMA and AMSTAR-2 guidelines, with almost half of the systematic reviews being critically low to low methodological quality. Given the prevalence of alcohol use disorder, methodological and reporting quality recommendations are important to strengthening evidence informing CPGs.
AB - Background: As Clinical Practice Guidelines (CPGs) provide effective guidance for providing medical care for individuals with alcohol use disorder (AUD), the evidence behind them should be robust. Objective: Our primary objective was to critically appraise the methodological and reporting quality of systematic reviews cited within CPGs regarding the treatment of AUD. Our secondary objective was to determine how frequently Cochrane Reviews were cited as justification and to evaluate appraisals between Cochrane and non-Cochrane reviews. Methods: We searched PubMed to identify CPGs for the treatment of AUD published between 2015 and 2021. Systematic reviews included in each CPG were evaluated using the Preferred Reporting Instrument for Systematic Reviews and Meta-Analyses (PRISMA) and a validated quality assessment tool (AMSTAR-2). Additional study characteristics were recorded. Results: From the screening process, 98 systematic reviews from 6 CPGs met inclusion criteria. PRISMA adherence ranged from 72% to 85% (mean of 79%). AMSTAR-2 adherence ranged from 52% to 73% (mean of 68%). AMSTAR appraisal ratings found 32 (35.6%) critically low, 10 (11.1%) low, 35 (38.9%) moderate, and only 13 (14.4%) high systematic reviews. Cochrane systematic reviews displayed greater PRISMA (0.92 vs. 0.75: p < 0.001) and AMSTAR-2 (0.90 vs. 0.61.; p < 0.001) scores compared to the non-Cochrane studies. Conclusion: Systematic reviews included in CPGs for AUD treatment showed variable adherence to PRISMA and AMSTAR-2 guidelines, with almost half of the systematic reviews being critically low to low methodological quality. Given the prevalence of alcohol use disorder, methodological and reporting quality recommendations are important to strengthening evidence informing CPGs.
KW - Alcohol-use disorder
KW - AMSTAR
KW - Clinical Practice Guidelines
KW - Evidence-Based Medicine
KW - PRISMA
KW - Systematic Review Methodology
UR - http://www.scopus.com/inward/record.url?scp=85123127519&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2022.109287
DO - 10.1016/j.drugalcdep.2022.109287
M3 - Review article
C2 - 35063840
AN - SCOPUS:85123127519
SN - 0376-8716
VL - 232
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 109287
ER -