Abstract
Background and Objective
Procedures to relieve pain are performed frequently but there are concerns about patient selection, appropriate image‐guidance, frequency, and training for physicians. Patients, healthcare providers, policymakers, and licensing bodies seek evidence‐based recommendations to use these interventions judiciously. In this review we appraised the methodological quality of recent clinical practice guidelines (CPGs) for interventional pain procedures.
Database and Data Treatment
A systematic search of the medical literature was performed. Three trained appraisers independently evaluated the methodological quality of the CPGs using a validated instrument, the Appraisal of Guidelines in Research and Evaluation II (AGREE‐II). Six domains were considered: 1) score and purpose; 2) stakeholder involvement; 3) rigour of development; 4) clarity of presentation; 5) applicability; and 6) editorial independence. A total of 23 items were scored. CPGs were deemed “high quality” if a mean scaled score above 60% for rigour of development and for two other domains was obtained.
Results
Mean scaled domain quality scores ranged from 61.72% to 69.99%. Despite being based on modest levels of evidence, two of the four included CPGs were considered to be of high methodological quality. The AGREE II scores across the four guidelines exhibited good inter‐rater reliability. None of the guidelines involved key stakeholders such as patients, other healthcare providers, and payers.
Conclusions
All four CPGs were limited by a weak execution of the guideline development process. There is a need to develop methodologically‐sound evidence‐based guidelines for use of interventional pain procedures using a rigorous process that involves all relevant stakeholders.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/39lTigv
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