PURPOSE: To assess the methodologic quality of guidelines for the management of low back pain (LBP) and compare their recommendations. METHODS: No ethics committee approval was needed for this systematic review. In March 2017, a systematic search was performed using MEDLINE, EMBASE, National Guideline Clearinghouse, and National Institute for Health and Clinical Excellence to find practice guidelines of assessment and management of LBP. The evaluation of guidelines quality was performed independently by four authors using the AGREE II tool, and the results were compared with previous appraisals performed in 2004 and 2009. RESULTS: Of 114 retrieved guidelines, eight were appraised. All except one reached the level of "acceptable" in overall result, with two of them reaching the highest scores. Only two guidelines reached a level of "acceptable" in every domain; the others had at least one domain with low scores. The guidelines had the higher scores (range = 63-94%) on "Scope and purpose" and "Clarity of presentation" (47-89%). "Stakeholder Involvement" has the highest variability between the guidelines results (40-96%). "Rigor of Development" reached an intermediate mean result (34-90%), "Applicability" (42-70%), and "Editorial Independence" (38-85%). Only three guidelines had a radiologist among authors and reached higher scores compared to guidelines without a radiologist among the authors. Compared to previous assessments, low-level guidelines were 53% in 2004, 36% in 2009, and 13% in 2017. CONCLUSIONS: Considering all guidelines, only one had a "low" overall score, while half of them were rated as of "high" quality. Future guidelines might take this into account to improve clinical applicability.

A critical appraisal of the quality of low back pain practice guidelines using the AGREE II tool and comparison with previous evaluations : a EuroAIM initiative / F.M. Doniselli, M. Zanardo, L. Manfrè, G.D.E. Papini, A. Rovira, F. Sardanelli, L.M. Sconfienza, E. Arana. - In: EUROPEAN SPINE JOURNAL. - ISSN 0940-6719. - 27:11(2018 Nov), pp. 2781-2790. [10.1007/s00586-018-5763-1]

A critical appraisal of the quality of low back pain practice guidelines using the AGREE II tool and comparison with previous evaluations : a EuroAIM initiative

F.M. Doniselli;M. Zanardo
;
G.D.E. Papini;F. Sardanelli;L.M. Sconfienza;
2018

Abstract

PURPOSE: To assess the methodologic quality of guidelines for the management of low back pain (LBP) and compare their recommendations. METHODS: No ethics committee approval was needed for this systematic review. In March 2017, a systematic search was performed using MEDLINE, EMBASE, National Guideline Clearinghouse, and National Institute for Health and Clinical Excellence to find practice guidelines of assessment and management of LBP. The evaluation of guidelines quality was performed independently by four authors using the AGREE II tool, and the results were compared with previous appraisals performed in 2004 and 2009. RESULTS: Of 114 retrieved guidelines, eight were appraised. All except one reached the level of "acceptable" in overall result, with two of them reaching the highest scores. Only two guidelines reached a level of "acceptable" in every domain; the others had at least one domain with low scores. The guidelines had the higher scores (range = 63-94%) on "Scope and purpose" and "Clarity of presentation" (47-89%). "Stakeholder Involvement" has the highest variability between the guidelines results (40-96%). "Rigor of Development" reached an intermediate mean result (34-90%), "Applicability" (42-70%), and "Editorial Independence" (38-85%). Only three guidelines had a radiologist among authors and reached higher scores compared to guidelines without a radiologist among the authors. Compared to previous assessments, low-level guidelines were 53% in 2004, 36% in 2009, and 13% in 2017. CONCLUSIONS: Considering all guidelines, only one had a "low" overall score, while half of them were rated as of "high" quality. Future guidelines might take this into account to improve clinical applicability.
AGREE II; Guidelines; Low back pain; Lumbar pain; Systematic review
Settore MED/36 - Diagnostica per Immagini e Radioterapia
nov-2018
Article (author)
File in questo prodotto:
File Dimensione Formato  
Doniselli_et_al-2018-European_Spine_Journal.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 1.44 MB
Formato Adobe PDF
1.44 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
10.1007_s00586-018-5763-1.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 1.46 MB
Formato Adobe PDF
1.46 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/588890
Citazioni
  • ???jsp.display-item.citation.pmc??? 6
  • Scopus 19
  • ???jsp.display-item.citation.isi??? 20
social impact