Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

Guía de Práctica Clínica

 

Evaluación de la calidad de las guías de práctica clínica sobre enfermedad vascular cerebral aguda mediante la herramienta AGREE II. Quality assessment of clinical practice guidelines on stroke using the AGREE II tool

Objetive: Evaluate the quality assessment of the treatment guidelines for stroke between 2010 and 2021.

Methods: Evaluation by AGREE II instrument. Intraclass correlation was performed for two observers, and it was analyzed the consensus on blood pressure goals and the use of prehospital scales.

Results: 21 clinical practice guidelines were included. The consensus between observers was 0.88 (95% CI: 0.69-0.95). The highest score was for clarity of presentation, while the lowest was for applicability. Nine guidelines (42.9%) were “recommended,” seven were “not recommended” (33.3%) and five were “recommended, but with modifications.” There is consensus on the blood pressure goals in the initial phase. The Fast scale was the most recommended.

Conclusions: Less than half of the guidelines analyzed were recommended for clinical use. Since 2016, the guidelines have shown substantial improvements in their quality. Implementing and actively utilizing the guidelines demands strengthening the applicability and editorial independence.

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Palabras clave: calidad, enfermedad vascular cerebral aguda, Guía de Práctica Clínica,

Keywords: clinical practice guideline, quality, stroke,

Multiple Sclerosis: A Review Of The Clinical Practice Guidelines. Esclerosis Múltiple: Una Revisión de Las Guías de Práctica Clínica

Neurological disorders are considered as one of the serious issues worldwide. While, many of the disorders have cure, there are still neurological diseases that lacks of curative treatment. Multiple sclerosis is one of them. It doesn’t have any cure, and therefore the prognosis of the disease is not so good. For this reason, the attention of the healthcare providers is mostly on the clinical management of the patients suffering from multiple sclerosis. The available literature for the clinical guidelines is into various dimensions, with a central focus to care the patients according to the evidence-based recommendations and rationales. A narrative review methodology is used to identify, evaluate, and analyze the available clinical guidelines worldwide. In total, ten clinical guidelines were found out of which only two fulfilled the quality guideline criteria. A quality guideline is the one in which four components are present: systematic review, meta-analysis, expert feedback and levels of recommendations. 2/10 clinical guidelines is a very less number which clearly indicates that there are many loop holes that need to be fixed in order to have a good pool of clinically evident recommendations.

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Palabras clave: Enfoque GRADE, esclerosis múltiple, Guía de Práctica Clínica, Práctica Clínica Basada en la Evidencia,

Keywords: Evidence-Based Practice, GRADE Approach, multiple sclerosis, Practice Guideline,
 
 
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