Valoración crítica de la guía colombiana de práctica clínica para la demencia con los instrumentos AGREE-II y el AGREE-REX

Abstract

Introduction

Major neurocognitive disorder is characterized by substantial cognitive decline from a previous level of increased performance in one or more cognitive domains. It is a chronic, progressive syndrome associated with significant disability and dependency in adults, which currently accounts for 11.9% of the years lived with disability due to non-communicable diseases. Colombia recently adopted a guide for this pathology.

Objective

To evaluate the methodological quality, credibility, and applicability of the Colombian clinical practice guideline (CPG) for major neurocognitive disorders.

Methodology

An academic group of seven evaluators was standardized to evaluate the guide and its recommendations through the AGREE-II and AGREE-REX instruments.

Results

The evaluations were given in the range of 0.0–1.0, with 0.7 as the cut-off point for appropriate quality. Overall AGREE-II score was 0.72. Scores > 0.70 were obtained except in the domains “participation of those involved” (0.65) and “applicability” (0.60). For the recommendations group-specific assessment carried out with the AGREE-REX, unfavorable results were obtained in general, with the quality rating being lower than the assessment of the suitability of the use of the recommendations.

Conclusión

Adopting the Colombian CPG for dementia was a rigorous methodological process, while the practice recommendations were rated as having low applicability. It is necessary to strengthen the generation and synthesis of evidence at the national level to provide a greater local context and favor the applicability of clinical practice recommendations.