Quality evaluation of French guidelines in primary care infectious disease: An AGREE II assessment.

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2024-10-02 DOI:10.1111/jep.14145

Kenza Akhamlich, Eulalie Gillet-Lecourt, Mikaël Bouchard, Rémy Boussageon

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Abstract

Rationale: Antibiotic prescription, its nature and its duration are a very common decision-making situation in primary care practice. Clinical practice guidelines (CPGs) are regularly emitted by various organisations on this topic.

Aims and objectives: Our goal is to run a quality appraisal of the current French guidelines, for the most common primary care infectious pathologies.

Method: We collected all primary care CPGs that are currently prevailing in France through a systematic review of the french website Antibioclic®. For each of these guidelines, a quality assessment was run by 3 independent reviewers, by means of the Appraisal of Guidelines for REsearch & Evaluation II instrument. The main outcome was a 'reliability score', defined as the sum of the scores in domains 'rigour of development' and 'editorial independence'. To be considered 'reliable', the CPG had to reach a 60% threshold in these two domains. Secondary outcomes were as follows: global quality score of CPGs, number and ratio of CPGs for which a systematic review has been conducted during its conception.

Results: Over the 43 CPGs that have been assessed, none reached the 60%-threshold as to the reliability score. Only one CPG (2.33%) gets an over-60% quality assessment in the domain of rigour of development (D3), whereas three CPGs (6.98%) reach this threshold in the domain of editorial independence (D6). One CPG (2.33%) met the quality threshold of 60% as to overall assessment. Rigour of development and editorial independence are the domains that obtained the lowest average score, respectively, 11% and 21%. Overall assessment received an average score of 29%. A systematic review of the literature was mentioned for 10 CPGs (23.26%).

Conclusion: There is a lack of quality in the development process of the current French guidelines in primary care infectiology. This process should be reconsidered, with higher insistence as to its quality.

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法国初级保健传染病指南的质量评估：AGREE II 评估。

理由：抗生素处方、其性质和持续时间是初级保健实践中非常常见的决策情况。临床实践指南（CPG）由不同组织定期发布：我们的目标是针对最常见的初级医疗感染性病症，对现行的法国指南进行质量评估：方法：我们通过对法国网站 Antibioclic® 的系统性审查，收集了目前在法国流行的所有初级保健 CPG。每份指南都由 3 位独立评审员通过 "研究与评估指南评估 II "工具进行质量评估。主要结果是 "可靠性得分"，即 "制定的严谨性 "和 "编辑的独立性 "两个方面得分的总和。CPG 在这两个领域的得分必须达到 60% 的临界值，才能被视为 "可靠"。次要结果如下：CPG 的总体质量得分，以及在其构思过程中进行过系统审查的 CPG 的数量和比例：在接受评估的 43 份 CPG 中，没有一份的可靠性得分达到 60% 的阈值。只有一份 CPG（2.33%）在开发严谨性（D3）方面的质量评估超过了 60%，而在编辑独立性（D6）方面，有三份 CPG（6.98%）达到了这一门槛。一份国家方案指南（2.33%）在总体评估方面达到了 60% 的质量阈值。开发的严谨性和编辑的独立性是平均得分最低的领域，分别为 11% 和 21%。总体评估的平均得分为 29%。有 10 份 CPG（23.26%）提到了文献的系统回顾：结论：法国现行的基层医疗感染学指南在制定过程中存在质量问题。结论：目前法国初级医疗感染学指南的制定过程缺乏质量，应重新考虑这一过程，并提高其质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.