Variable methodological quality and use found in systematic reviews referenced in STEMI clinical practice guidelines

Jared Scott, Benjamin Howard, Philip Sinnett, Michael Schiesel, Jana Baker, Patrick Henderson, Matt Vassar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. Methods We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English. We retrieved SRs from the reference sections using a combination of keywords and hand searching. Two investigators scored eligible SRs using AMSTAR and PRISMA. Results We included four CPGs. We extracted 71 unique SRs. These SRs received AMSTAR scores ranging from 1 (low) to 9 (high) on an 11-point scale. All CPGs consistently underperformed in areas including disclosure of funding sources, risk of bias, and publication bias according to AMSTAR. PRISMA checklist completeness ranged from 44% to 96%. The PRISMA scores indicated that SRs did not provide a full search strategy, study protocol and registration, assessment of publication bias or report funding sources. Only one SR was referenced in all four CPGs. All CPGs omitted a large subset of available SRs cited by other guidelines. Conclusions Our study demonstrates the variable quality of SRs used to establish recommendations within guidelines included in our sample. Although guideline developers have acknowledged this variability, it remains a significant finding that needs to be addressed further. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Original languageEnglish
Pages (from-to)1828-1835
Number of pages8
JournalAmerican Journal of Emergency Medicine
Volume35
Issue number12
DOIs
StatePublished - 1 Dec 2017

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Practice Guidelines
Guidelines
Publication Bias
Organized Financing
Disclosure
Checklist
ST Elevation Myocardial Infarction
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Research

Keywords

  • AMSTAR
  • Acute coronary syndrome
  • Clinical practice guidelines
  • PRISMA
  • ST-elevated myocardial infarction
  • Systematic reviews

Cite this

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title = "Variable methodological quality and use found in systematic reviews referenced in STEMI clinical practice guidelines",
abstract = "Background The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. Methods We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English. We retrieved SRs from the reference sections using a combination of keywords and hand searching. Two investigators scored eligible SRs using AMSTAR and PRISMA. Results We included four CPGs. We extracted 71 unique SRs. These SRs received AMSTAR scores ranging from 1 (low) to 9 (high) on an 11-point scale. All CPGs consistently underperformed in areas including disclosure of funding sources, risk of bias, and publication bias according to AMSTAR. PRISMA checklist completeness ranged from 44{\%} to 96{\%}. The PRISMA scores indicated that SRs did not provide a full search strategy, study protocol and registration, assessment of publication bias or report funding sources. Only one SR was referenced in all four CPGs. All CPGs omitted a large subset of available SRs cited by other guidelines. Conclusions Our study demonstrates the variable quality of SRs used to establish recommendations within guidelines included in our sample. Although guideline developers have acknowledged this variability, it remains a significant finding that needs to be addressed further. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.",
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Variable methodological quality and use found in systematic reviews referenced in STEMI clinical practice guidelines. / Scott, Jared; Howard, Benjamin; Sinnett, Philip; Schiesel, Michael; Baker, Jana; Henderson, Patrick; Vassar, Matt.

In: American Journal of Emergency Medicine, Vol. 35, No. 12, 01.12.2017, p. 1828-1835.

Research output: Contribution to journalArticle

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T1 - Variable methodological quality and use found in systematic reviews referenced in STEMI clinical practice guidelines

AU - Scott, Jared

AU - Howard, Benjamin

AU - Sinnett, Philip

AU - Schiesel, Michael

AU - Baker, Jana

AU - Henderson, Patrick

AU - Vassar, Matt

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. Methods We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English. We retrieved SRs from the reference sections using a combination of keywords and hand searching. Two investigators scored eligible SRs using AMSTAR and PRISMA. Results We included four CPGs. We extracted 71 unique SRs. These SRs received AMSTAR scores ranging from 1 (low) to 9 (high) on an 11-point scale. All CPGs consistently underperformed in areas including disclosure of funding sources, risk of bias, and publication bias according to AMSTAR. PRISMA checklist completeness ranged from 44% to 96%. The PRISMA scores indicated that SRs did not provide a full search strategy, study protocol and registration, assessment of publication bias or report funding sources. Only one SR was referenced in all four CPGs. All CPGs omitted a large subset of available SRs cited by other guidelines. Conclusions Our study demonstrates the variable quality of SRs used to establish recommendations within guidelines included in our sample. Although guideline developers have acknowledged this variability, it remains a significant finding that needs to be addressed further. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

AB - Background The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. Methods We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English. We retrieved SRs from the reference sections using a combination of keywords and hand searching. Two investigators scored eligible SRs using AMSTAR and PRISMA. Results We included four CPGs. We extracted 71 unique SRs. These SRs received AMSTAR scores ranging from 1 (low) to 9 (high) on an 11-point scale. All CPGs consistently underperformed in areas including disclosure of funding sources, risk of bias, and publication bias according to AMSTAR. PRISMA checklist completeness ranged from 44% to 96%. The PRISMA scores indicated that SRs did not provide a full search strategy, study protocol and registration, assessment of publication bias or report funding sources. Only one SR was referenced in all four CPGs. All CPGs omitted a large subset of available SRs cited by other guidelines. Conclusions Our study demonstrates the variable quality of SRs used to establish recommendations within guidelines included in our sample. Although guideline developers have acknowledged this variability, it remains a significant finding that needs to be addressed further. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

KW - AMSTAR

KW - Acute coronary syndrome

KW - Clinical practice guidelines

KW - PRISMA

KW - ST-elevated myocardial infarction

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JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

SN - 0735-6757

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