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A critical appraisal of the quality of low back pain practice guidelines using the AGREE II tool and comparison with previous evaluations: a EuroAIM initiative.
Eur Spine J 2018; 27(11):2781-2790ES

Abstract

PURPOSE

To assess the methodologic quality of guidelines for the management of low back pain (LBP) and compare their recommendations.

METHODS

No ethics committee approval was needed for this systematic review. In March 2017, a systematic search was performed using MEDLINE, EMBASE, National Guideline Clearinghouse, and National Institute for Health and Clinical Excellence to find practice guidelines of assessment and management of LBP. The evaluation of guidelines quality was performed independently by four authors using the AGREE II tool, and the results were compared with previous appraisals performed in 2004 and 2009.

RESULTS

Of 114 retrieved guidelines, eight were appraised. All except one reached the level of "acceptable" in overall result, with two of them reaching the highest scores. Only two guidelines reached a level of "acceptable" in every domain; the others had at least one domain with low scores. The guidelines had the higher scores (range = 63-94%) on "Scope and purpose" and "Clarity of presentation" (47-89%). "Stakeholder Involvement" has the highest variability between the guidelines results (40-96%). "Rigor of Development" reached an intermediate mean result (34-90%), "Applicability" (42-70%), and "Editorial Independence" (38-85%). Only three guidelines had a radiologist among authors and reached higher scores compared to guidelines without a radiologist among the authors. Compared to previous assessments, low-level guidelines were 53% in 2004, 36% in 2009, and 13% in 2017.

CONCLUSIONS

Considering all guidelines, only one had a "low" overall score, while half of them were rated as of "high" quality. Future guidelines might take this into account to improve clinical applicability.

Authors+Show Affiliations

Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy.PhD Course in Integrative Biomedical Research, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli, 31, 20133, Milan, Italy. moreno.zanardo@unimi.it.Department of Neurosurgery/Interventional Radiology, Minimal Invasive Spine Therapy, Institute of Oncology in Mediterranean (IOM), Viagrande, Catania, Italy.Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.Section of Neuroradiology and Magnetic Resonance Unit, Department of Radiology (IDI), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20100, Milano, Italy.Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20100, Milano, Italy. Unità Operativa di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.Spanish Back Pain Research Network, Kovacs Foundation, Paseo de Mallorca 36, 07012, Palma de Mallorca, Spain. Department of Radiology, Valencian Oncology Institute Foundation, C/Professor Beltrán Báguena, 19, 46009, Valencia, Spain.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

30220040

Citation

Doniselli, Fabio Martino, et al. "A Critical Appraisal of the Quality of Low Back Pain Practice Guidelines Using the AGREE II Tool and Comparison With Previous Evaluations: a EuroAIM Initiative." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 27, no. 11, 2018, pp. 2781-2790.
Doniselli FM, Zanardo M, Manfrè L, et al. A critical appraisal of the quality of low back pain practice guidelines using the AGREE II tool and comparison with previous evaluations: a EuroAIM initiative. Eur Spine J. 2018;27(11):2781-2790.
Doniselli, F. M., Zanardo, M., Manfrè, L., Papini, G. D. E., Rovira, A., Sardanelli, F., ... Arana, E. (2018). A critical appraisal of the quality of low back pain practice guidelines using the AGREE II tool and comparison with previous evaluations: a EuroAIM initiative. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 27(11), pp. 2781-2790. doi:10.1007/s00586-018-5763-1.
Doniselli FM, et al. A Critical Appraisal of the Quality of Low Back Pain Practice Guidelines Using the AGREE II Tool and Comparison With Previous Evaluations: a EuroAIM Initiative. Eur Spine J. 2018;27(11):2781-2790. PubMed PMID: 30220040.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A critical appraisal of the quality of low back pain practice guidelines using the AGREE II tool and comparison with previous evaluations: a EuroAIM initiative. AU - Doniselli,Fabio Martino, AU - Zanardo,Moreno, AU - Manfrè,Luigi, AU - Papini,Giacomo Davide Edoardo, AU - Rovira,Alex, AU - Sardanelli,Francesco, AU - Sconfienza,Luca Maria, AU - Arana,Estanislao, Y1 - 2018/09/15/ PY - 2018/07/23/received PY - 2018/09/09/accepted PY - 2018/9/17/pubmed PY - 2019/10/29/medline PY - 2018/9/17/entrez KW - AGREE II KW - Guidelines KW - Low back pain KW - Lumbar pain KW - Systematic review SP - 2781 EP - 2790 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 27 IS - 11 N2 - PURPOSE: To assess the methodologic quality of guidelines for the management of low back pain (LBP) and compare their recommendations. METHODS: No ethics committee approval was needed for this systematic review. In March 2017, a systematic search was performed using MEDLINE, EMBASE, National Guideline Clearinghouse, and National Institute for Health and Clinical Excellence to find practice guidelines of assessment and management of LBP. The evaluation of guidelines quality was performed independently by four authors using the AGREE II tool, and the results were compared with previous appraisals performed in 2004 and 2009. RESULTS: Of 114 retrieved guidelines, eight were appraised. All except one reached the level of "acceptable" in overall result, with two of them reaching the highest scores. Only two guidelines reached a level of "acceptable" in every domain; the others had at least one domain with low scores. The guidelines had the higher scores (range = 63-94%) on "Scope and purpose" and "Clarity of presentation" (47-89%). "Stakeholder Involvement" has the highest variability between the guidelines results (40-96%). "Rigor of Development" reached an intermediate mean result (34-90%), "Applicability" (42-70%), and "Editorial Independence" (38-85%). Only three guidelines had a radiologist among authors and reached higher scores compared to guidelines without a radiologist among the authors. Compared to previous assessments, low-level guidelines were 53% in 2004, 36% in 2009, and 13% in 2017. CONCLUSIONS: Considering all guidelines, only one had a "low" overall score, while half of them were rated as of "high" quality. Future guidelines might take this into account to improve clinical applicability. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/30220040/A_critical_appraisal_of_the_quality_of_low_back_pain_practice_guidelines_using_the_AGREE_II_tool_and_comparison_with_previous_evaluations:_a_EuroAIM_initiative_ L2 - https://doi.org/10.1007/s00586-018-5763-1 DB - PRIME DP - Unbound Medicine ER -