A methodological assessment of diabetic foot syndrome clinical practice guidelines

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Title: A methodological assessment of diabetic foot syndrome clinical practice guidelines
Authors: Tan, K
Goodall, R
Hughes, W
Langridge, B
Shalhoub, J
Davies, A
Item Type: Journal Article
Abstract: Objectives: Diabetic foot syndrome (DFS) contributes to significant morbidity in diabetic patients. Diagnostic and therapeutic approaches to DFS may be summarised in clinical practice guidelines (CPGs) to aid clinical practice but may only benefit patients if the CPG is of high quality. This study determines the methodological quality of DFS CPGs using a validated assessment tool to identify CPGs adequate for use in clinical practice. Methods: Medline, EMBASE and CPG databases were searched to 31st May 2019. Reference lists were also searched. Full text English evidence-based DFS CPGs were included. CPGs based on expert consensus, guideline summaries or only available if purchased were excluded. Four reviewers independently assessed methodological quality using Appraisal of Guidelines for Research and Evaluation II instrument. An overall guideline assessment scaled score of ≥80% was considered of adequate quality to recommend use. Results: 16 CPGs were identified. Good inter-reviewer reliability (ICC 0.985, 95% CI 0.980-0.989) was achieved. Poor scores were noted in domains 2 (stakeholder involvement), 5 (applicability), and 6 (editorial independence). Significant methodological heterogeneity was observed in all domains with the most noted in domain 6 (mean scaled score 43.2±32.1%). Four CPGs achieved overall assessment scores of ≥80%. Conclusion: Four CPGs were considered adequate for clinical practice based on methodological quality. However, elements of methodological quality were still lacking, and all CPGs showed areas for improvement, potentially through increased multidisciplinary team involvement and trial application of recommendations. Methodological rigour may be improved using structured approaches with validated CPG creation tools in the future. Future work should also assess recommendation accuracy using available validated assessment tools.
Issue Date: 1-Aug-2020
Date of Acceptance: 16-Mar-2020
URI: http://hdl.handle.net/10044/1/78932
DOI: 10.1016/j.ejvs.2020.04.028
ISSN: 1078-5884
Publisher: Elsevier
Start Page: 274
End Page: 281
Journal / Book Title: European Journal of Vascular and Endovascular Surgery
Volume: 60
Issue: 2
Copyright Statement: Crown Copyright © 2020 Published by Elsevier B.V. on behalf of European Society for Vascular Surgery. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Clinical practice guidelines
Diabetic foot
Diabetic foot syndrome
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Cardiovascular System & Hematology
Publication Status: Published
Online Publication Date: 2020-07-04
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine

This item is licensed under a Creative Commons License Creative Commons