Quality assessment of clinical practice guidelines for adaptation in burn injury

Abstract Objectives A number of clinical practice guidelines (CPGs) are available for managing burn injury patients but clinical practice is highly variable. We report the first steps to trans-contextual adaptation of international burn CPGs to local settings. Methods Key clinical topics and questio...

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Bibliographic Details
Published in:Burns 2010-08, Vol.36 (5), p.606-615
Main Authors: Kis, E, Szegesdi, I, Dobos, E, Nagy, E, Boda, K, Kemény, L, Horvath, A.R
Format: Article
Language:English
Subjects:
Biological and medical sciences
Burn injury
Burns
Burns - therapy
Critical Care
Delivery of Health Care - organization & administration
Evidence-based medicine
Evidence-Based Medicine - standards
Guideline adaptation
Guidelines
Humans
Intensive care
Medical sciences
Miscellaneous
Practice Guidelines as Topic - standards
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality
Quality of Health Care - standards
Traumas. Diseases due to physical agents
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Summary:Abstract Objectives A number of clinical practice guidelines (CPGs) are available for managing burn injury patients but clinical practice is highly variable. We report the first steps to trans-contextual adaptation of international burn CPGs to local settings. Methods Key clinical topics and questions to be covered in the final guideline were defined and prioritized. Systematic search between 1990 and 2008 retrieved 546 citations, of which 24 were CPGs on the general and intensive care of burn patients. Assessment of the clinical content of CPGs was carried out. Methodological quality of CPGs was evaluated using the AGREE instrument. Results Of the 24 CPGs evaluated, 10 (42%) were evidence-based. All major burn topics were covered by at least one CPG, but no single CPG addressed all areas important in terms of outcomes. According to the AGREE criteria, 2 CPGs (8%) were strongly recommended, 14 with provisos or alterations (58%) and the rest were not recommended for adaptation. Conclusions Although existing CPGs for the management of burn may accurately reflect agreed clinical practice, most performed poorly when evaluated for methodological quality. Future CPG efforts addressing these methodological shortcomings would add substantially to the improved management of burned patients.
ISSN:0305-4179
1879-1409
DOI:10.1016/j.burns.2009.08.017