The Quality of Clinical Practice Guidelines and Consensuses on the Management of Primary Aldosteronism: A Critical Appraisal

Frontiers in Medicine

article

Zhe Meng¹  Liang Zhou³  Zhe Dai²  Chang Xu⁵  Guofeng Qian⁶  Mou Peng⁷  Yuchun Zhu²  Joey S. W. Kwong⁸  Xinghuan Wang¹ 

[1] Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan University;Department of Adrenal Hypertension, Zhongnan Hospital of Wuhan University, Wuhan University;Department of Urology, West China Hospital, Sichuan University;Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan University;Chinese Evidence Based Medicine Center, West China Hospital, Sichuan University;Department of Urology, The First Hospital of Zhejiang University, Zhejiang University;Department of Urology, The Second Hospital of Xiangya, Zhongnan University;JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong

关键词: primary aldosteronism;    clinical practice guideline;    quality assessment;    AGREE II;    systematic review;   

DOI  :  10.3389/fmed.2020.00136

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Several guidelines and expert consensuses have been developed for management of primary aldosteronism (PA). It is important to understand the detailed recommendations and quality of these guidelines to help physicians make informed and reliable decision. Methods: PubMed, EMBASE, and three websites were searched for practice guidelines or consensuses of PA from inception to January 24, 2019. We summarized the major recommendations on the management of PA from these guidelines and consensuses. The Appraisal of Guidelines for Research and Evaluation II was used to assess quality of the included guidelines and consensuses. Results: We identified three clinical practice guidelines and three consensus statements. Most of the recommendations on the diagnosis and treatment of PA from these guidelines and consensuses were consistent. Some minor conflicts were recorded for patient's screen and confirmation test. All included guideline documents have a good quality (score, >70%) on the scope and purpose (mean score, 81.02%) and clarity of presentation of the recommendations (mean score, 86.88%). However, the reporting for the stakeholder involvement (mean score, 54.32%) and applicability (mean score, 47.92%) were insufficient. There was an insufficient rigorousness in most of the guideline documents (mean score, 45.56%) on the development process. The Endocrine Society practice guideline 2016 ranked highest in quality (score, 81.13%). Conclusions: Existing guideline documents provided valuable recommendations on the management of PA, but further efforts are needed to improve the methodological quality. The Endocrine Society practice guideline 2016 was recommended for use.

【 授权许可】

CC BY