Global emergency care clinical practice guidelines: A landscape analysis
Introduction: An adaptive guideline development method, as opposed to a de novo guideline development, is dependent on access to existing high-quality up-to-date clinical practice guidelines (CPGs). We described the characteristics and quality of CPGs relevant to prehospital care worldwide, in order...
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doaj-78dda30d595341128cedee441e2e699a2020-11-25T00:39:57ZengElsevierAfrican Journal of Emergency Medicine2211-419X2018-12-0184158163Global emergency care clinical practice guidelines: A landscape analysisMichael McCaul0Mike Clarke1Stevan R. Bruijns2Peter W. Hodkinson3Ben de Waal4Jennifer Pigoga5Lee A. Wallis6Taryn Young7Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, South Africa; Corresponding author.Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, South Africa; Centre for Public Health, Queen’s University Belfast, Northern Ireland, United KingdomDivision of Emergency Medicine, University of Cape Town, South AfricaDivision of Emergency Medicine, University of Cape Town, South AfricaDepartment of Emergency Medical Sciences, Cape Peninsula University of Technology, South AfricaDivision of Emergency Medicine, University of Cape Town, South AfricaDivision of Emergency Medicine, University of Cape Town, South Africa; Division of Emergency Medicine, Stellenbosch University, South AfricaCentre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, South AfricaIntroduction: An adaptive guideline development method, as opposed to a de novo guideline development, is dependent on access to existing high-quality up-to-date clinical practice guidelines (CPGs). We described the characteristics and quality of CPGs relevant to prehospital care worldwide, in order to strengthen guideline development in low-resource settings for emergency care. Methods: We conducted a descriptive study of a database of international CPGs relevant to emergency care produced by the African Federation for Emergency Medicine (AFEM) CPG project in 2016. Guideline quality was assessed with the AGREE II tool, independently and in duplicate. End-user documents such as protocols, care pathways, and algorithms were excluded. Data were imported, managed, and analysed in STATA 14 and R. Results: In total, 276 guidelines were included. Less than 2% of CPGs originated from low- and middle income-countries (LMICs); only 15% (n = 38) of guidelines were prehospital specific, and there were no CPGs directly applicable to prehospital care in LMICs. Most guidelines used de novo methods (58%, n = 150) and were produced by professional societies or associations (63%, n = 164), with the minority developed by international bodies (3%, n = 7). National bodies, such as the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN), produced higher quality guidelines when compared to international guidelines, professional societies, and clinician/academic-produced guidelines. Guideline quality varied across topics, subpopulations and producers. Resource-constrained guideline developers that cannot afford de novo guideline development have access to an expanding pool of high-quality prehospital guidelines to translate to their local setting. Discussion: Although some high-quality CPGs exist relevant to emergency care, none directly address the needs of prehospital care in LMICs, especially in Africa. Strengthening guideline development capacity, including adaptive guideline development methods that use existing high-quality CPGs, is a priority. Keywords: Emergency care, Prehospital, Guideline development, Scoping, Guideline qualityhttp://www.sciencedirect.com/science/article/pii/S2211419X18300752 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Michael McCaul Mike Clarke Stevan R. Bruijns Peter W. Hodkinson Ben de Waal Jennifer Pigoga Lee A. Wallis Taryn Young |
spellingShingle |
Michael McCaul Mike Clarke Stevan R. Bruijns Peter W. Hodkinson Ben de Waal Jennifer Pigoga Lee A. Wallis Taryn Young Global emergency care clinical practice guidelines: A landscape analysis African Journal of Emergency Medicine |
author_facet |
Michael McCaul Mike Clarke Stevan R. Bruijns Peter W. Hodkinson Ben de Waal Jennifer Pigoga Lee A. Wallis Taryn Young |
author_sort |
Michael McCaul |
title |
Global emergency care clinical practice guidelines: A landscape analysis |
title_short |
Global emergency care clinical practice guidelines: A landscape analysis |
title_full |
Global emergency care clinical practice guidelines: A landscape analysis |
title_fullStr |
Global emergency care clinical practice guidelines: A landscape analysis |
title_full_unstemmed |
Global emergency care clinical practice guidelines: A landscape analysis |
title_sort |
global emergency care clinical practice guidelines: a landscape analysis |
publisher |
Elsevier |
series |
African Journal of Emergency Medicine |
issn |
2211-419X |
publishDate |
2018-12-01 |
description |
Introduction: An adaptive guideline development method, as opposed to a de novo guideline development, is dependent on access to existing high-quality up-to-date clinical practice guidelines (CPGs). We described the characteristics and quality of CPGs relevant to prehospital care worldwide, in order to strengthen guideline development in low-resource settings for emergency care. Methods: We conducted a descriptive study of a database of international CPGs relevant to emergency care produced by the African Federation for Emergency Medicine (AFEM) CPG project in 2016. Guideline quality was assessed with the AGREE II tool, independently and in duplicate. End-user documents such as protocols, care pathways, and algorithms were excluded. Data were imported, managed, and analysed in STATA 14 and R. Results: In total, 276 guidelines were included. Less than 2% of CPGs originated from low- and middle income-countries (LMICs); only 15% (n = 38) of guidelines were prehospital specific, and there were no CPGs directly applicable to prehospital care in LMICs. Most guidelines used de novo methods (58%, n = 150) and were produced by professional societies or associations (63%, n = 164), with the minority developed by international bodies (3%, n = 7). National bodies, such as the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN), produced higher quality guidelines when compared to international guidelines, professional societies, and clinician/academic-produced guidelines. Guideline quality varied across topics, subpopulations and producers. Resource-constrained guideline developers that cannot afford de novo guideline development have access to an expanding pool of high-quality prehospital guidelines to translate to their local setting. Discussion: Although some high-quality CPGs exist relevant to emergency care, none directly address the needs of prehospital care in LMICs, especially in Africa. Strengthening guideline development capacity, including adaptive guideline development methods that use existing high-quality CPGs, is a priority. Keywords: Emergency care, Prehospital, Guideline development, Scoping, Guideline quality |
url |
http://www.sciencedirect.com/science/article/pii/S2211419X18300752 |
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