Reproducibility of the AGREE II Tool for Assessing the Methodological Quality of Clinical Practice Guidelines for the Management of Antithrombotic Agents in Patients Undergoing GI Endoscopy.


Journal

Journal of clinical gastroenterology
ISSN: 1539-2031
Titre abrégé: J Clin Gastroenterol
Pays: United States
ID NLM: 7910017

Informations de publication

Date de publication:
02 Sep 2024
Historique:
received: 20 03 2024
accepted: 05 08 2024
medline: 31 8 2024
pubmed: 31 8 2024
entrez: 30 8 2024
Statut: aheadofprint

Résumé

Clinical practice guidelines (CPGs) exist for the management of antithrombotic agents in the periendoscopic period; however, their methodological qualities vary. The Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool has been validated for the assessment of the methodological quality of CPGs; however, its reproducibility has not been assessed. The goal of this study was to assess the reproducibility of the AGREE II tool for CPGs published within the last 6 years for the management of antithrombotic agents in the periendoscopic period. A systematic search of PubMed and Embase databases was performed to identify eligible CPGs published between January 1, 2016 and April 14, 2022. The quality of the CPG was independently assessed by 6 reviewers using the AGREE II instrument. The reproducibility was summarized as weighted κ statistic and intraclass correlation coefficient using the SPSS statistical analysis package. The search yielded 343 citations with 7 CPGs from Europe, Asia, and the United States included in the critical appraisal. The overall mean weighted κ score across all guidelines was 0.300 (range, 0.093 to 0.384) indicating a fair agreement. The overall intraclass correlation coefficient was 0.462 (range, 0.175 to 0.570) for single measures and 0.837 (range, 0.560 to 0.888) for average measures indicating moderate reliability. Our study shows only a fair overall interobserver agreement in the methodological quality of the included CPGs. The results suggest the need for education and training of CPG raters to enhance the application of the AGREE II tool to improve its reproducibility.

Sections du résumé

BACKGROUND BACKGROUND
Clinical practice guidelines (CPGs) exist for the management of antithrombotic agents in the periendoscopic period; however, their methodological qualities vary. The Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool has been validated for the assessment of the methodological quality of CPGs; however, its reproducibility has not been assessed. The goal of this study was to assess the reproducibility of the AGREE II tool for CPGs published within the last 6 years for the management of antithrombotic agents in the periendoscopic period.
STUDY METHODS
A systematic search of PubMed and Embase databases was performed to identify eligible CPGs published between January 1, 2016 and April 14, 2022. The quality of the CPG was independently assessed by 6 reviewers using the AGREE II instrument. The reproducibility was summarized as weighted κ statistic and intraclass correlation coefficient using the SPSS statistical analysis package.
RESULTS RESULTS
The search yielded 343 citations with 7 CPGs from Europe, Asia, and the United States included in the critical appraisal. The overall mean weighted κ score across all guidelines was 0.300 (range, 0.093 to 0.384) indicating a fair agreement. The overall intraclass correlation coefficient was 0.462 (range, 0.175 to 0.570) for single measures and 0.837 (range, 0.560 to 0.888) for average measures indicating moderate reliability.
CONCLUSIONS CONCLUSIONS
Our study shows only a fair overall interobserver agreement in the methodological quality of the included CPGs. The results suggest the need for education and training of CPG raters to enhance the application of the AGREE II tool to improve its reproducibility.

Identifiants

pubmed: 39213007
doi: 10.1097/MCG.0000000000002069
pii: 00004836-990000000-00343
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

Références

Deitelzweig S, Keshishian A, Kang A, et al. Burden of major gastrointestinal bleeding among oral anticoagulant-treated non-valvular atrial fibrillation patients. Therap Adv Gastroenterol. 2021;14:1756284821997352.
Tang RS, Chan FK. Prevention of gastrointestinal events in patients on antithrombotic therapy in the peri-endoscopy period: review of new evidence and recommendations from recent guidelines. Dig Endosc. 2015;27:562–571.
Sadeghi A, Zali MR, Mohaghegh Shalmani H, et al. An algorithmic approach to gastrointestinal bleeding in patients receiving antithrombotic agents. Gastroenterol Hepatol Bed Bench. 2020;13:S8–S17.
Gnanapandithan K, Muniraj T. Management of antithrombotics around gastrointestinal procedures. StatPearls. Treasure Island, FL; 2022.
Vernooij RW, Sanabria AJ, Sola I, et al. Guidance for updating clinical practice guidelines: a systematic review of methodological handbooks. Implement Sci. 2014;9:3.
Brouwers MC, Kho ME, Browman GP, et al. Development of the AGREE II, part 2: assessment of validity of items and tools to support application. CMAJ. 2010;182:E472–E478.
Brouwers MC, Makarski J, Durocher LD, et al. E-learning interventions are comparable to user’s manual in a randomized trial of training strategies for the AGREE II. Implement Sci. 2011;6:81.
Chua M, Ming J, Chang SJ, et al. A critical review of recent clinical practice guidelines for pediatric urinary tract infection. Can Urol Assoc J. 2018;12:112–118.
Jacklin C, Tan M, Sravanam S, et al. Appraisal of international guidelines for cutaneous melanoma management using the AGREE II assessment tool. JPRAS Open. 2022;31:114–122.
McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22:276–282.
O’Donoghue KJM, Reed RD, Knight SR, et al. Critical appraisal of international clinical practice guidelines in kidney transplantation using the appraisal of guidelines for research and education II tool: a systematic review. Transplantation. 2018;102:1419–1439.
Babiker Mohamed MA, Abdelwahab Abdelkarim WA, Salih Aabdeen MA, et al. Evidence-based clinical practice guidelines for the management of perioperative hypothermia: systematic review, critical appraisal, and quality assessment with the AGREE II instrument. Ann Med Surg (Lond). 2022;79:103887.
Sephien A, Dayto DC, Reljic T, et al. A systematic critical appraisal of clinical practice guidelines in heart failure using the AGREE II Tool. Am J Cardiol. 2023;202:192–198.
MacDermid JC, Brooks D, Solway S, et al. Reliability and validity of the AGREE instrument used by physical therapists in assessment of clinical practice guidelines. BMC Health Serv Res. 2005;5:18.
Hoffmann-Esser W, Siering U, Neugebauer EAM, et al. Guideline appraisal with AGREE II: online survey of the potential influence of AGREE II items on overall assessment of guideline quality and recommendation for use. BMC Health Serv Res. 2018;18:143.
Dayto DC, Blonski W, Reljic T, et al. A systematic critical appraisal of clinical practice guidelines of antithrombotic agents in gastrointestinal endoscopy using the AGREE II tool. J Gastroenterol Hepatol. 2024;39:818–825.
Brouwers MC, Kho ME, Browman GP, et al. Development of the AGREE II, part 1: performance, usefulness and areas for improvement. CMAJ. 2010;182:1045–1052.
Brouwers MC, Spithoff K, Kerkvliet K, et al. Development and validation of a tool to assess the quality of clinical practice guideline recommendations. JAMA Netw Open. 2020;3:e205535.
Farcas A, Bataga S, Cijevschi C, et al. Gastrointestinal endoscopy in patients on direct oral anticoagulants. A consensus paper of the Romanian Society of Gastroenterology and Hepatology. J Gastrointestin Liver Dis. 2018;27:179–187.
Veitch AM, Radaelli F, Alikhan R, et al. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update. Gut. 2021;70:1611–1628.
Veitch AM, Radaelli F, Alikhan R, et al. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update. Endoscopy. 2021;53:947–969.
Kato M, Uedo N, Hokimoto S, et al. Guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment: 2017 appendix on anticoagulants including direct oral anticoagulants. Dig Endosc. 2018;30:433–440.
Chan FKL, Goh KL, Reddy N, et al. Management of patients on antithrombotic agents undergoing emergency and elective endoscopy: joint Asian Pacific Association of Gastroenterology (APAGE) and Asian Pacific Society for Digestive Endoscopy (APSDE) practice guidelines. Gut. 2018;67:405–417.
Lim H, Gong EJ, Min BH, et al. Clinical practice guideline for the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy. Clin Endosc. 2020;53:663–677.
Acosta RD, Abraham NS, Chandrasekhara V, et al. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc. 2016;83:3–16.
Abraham NS, Barkun AN, Sauer BG, et al. American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: management of anticoagulants and antiplatelets during acute gastrointestinal bleeding and the periendoscopic period. Am J Gastroenterol. 2022;117:542–558.
Guan B, Fan Y, Zheng R, et al. A critical appraisal of clinical practice guidelines on pharmacological treatments for spinal cord injury. Spine J. 2023;23:392–402.
Sanclemente G, Acosta JL, Tamayo ME, et al. Clinical practice guidelines for treatment of acne vulgaris: a critical appraisal using the AGREE II instrument. Arch Dermatol Res. 2014;306:269–277.
Coutinho SGB, Ricardo JC, Coutinho AIM, et al. The quality of guidelines for treatment of carotid artery disease: a critical appraisal using the AGREE II instrument. J Vasc Bras. 2022;21:e20220032.
Trust AR AGREE Enterprise Website. Accessed March 3, 2023. https://www.agreetrust.org/
Amer YS, Shaiba LA, Hadid A, et al. Quality assessment of clinical practice guidelines for neonatal sepsis using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument: a systematic review of neonatal guidelines. Front Pediatr. 2022;10:891572.
Zou B, Zhou Y, He Z, et al. A critical appraisal of urolithiasis clinical practice guidelines using the AGREE II instrument. Transl Androl Urol. 2023;12:977–988.
Jonsson A, Rasmussen-Barr E. Intra- and inter-rater reliability of movement and palpation tests in patients with neck pain: a systematic review. Physiother Theory Pract. 2018;34:165–180.
Lima JP, Tangamornsuksan W, Guyatt GH. Trustworthy evidence-based versus untrustworthy guidelines: detecting the difference. Fam Med Community Health. 2023;11:e002437.

Auteurs

Denisse Camille Dayto (DC)

Division of Liver Disease and Transplant Hepatology, Rutgers Health New Jersey Medical School, Newark, NJ.

Wojciech Blonski (W)

Division of Gastroenterology, James A Haley Veterans' Hospital, Tampa.
Department of Internal Medicine, Division of Digestive Diseases and Nutrition, University of South Florida Health, Tampa.

Tea Reljic (T)

Research Methodology and Biostatistics Core, Office of Research, University of South Florida, Tampa.

Farina Klocksieben (F)

Research Methodology and Biostatistics Core, Office of Research, University of South Florida, Tampa.

Jeffrey Gill (J)

Division of Gastroenterology, James A Haley Veterans' Hospital, Tampa.
Department of Internal Medicine, Division of Digestive Diseases and Nutrition, University of South Florida Health, Tampa.

Rene D Gomez-Esquivel (RD)

Department of Internal Medicine, Division of Digestive Diseases and Nutrition, University of South Florida Health, Tampa.

Brijesh Patel (B)

Division of Gastroenterology, James A Haley Veterans' Hospital, Tampa.
Department of Internal Medicine, Division of Digestive Diseases and Nutrition, University of South Florida Health, Tampa.

Pushpak Taunk (P)

Department of Internal Medicine, Division of Digestive Diseases and Nutrition, University of South Florida Health, Tampa.

Andrew Sephien (A)

Division of Cardiovascular Disease, University of Miami/Jackson Memorial Hospital, Miami, FL.

Camille Thelin (C)

Department of Internal Medicine, Division of Digestive Diseases and Nutrition, University of South Florida Health, Tampa.

Ambuj Kumar (A)

Research Methodology and Biostatistics Core, Office of Research, University of South Florida, Tampa.
Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa.

Classifications MeSH