Quality appraisal of clinical guidelines for recurrent urinary tract infections using AGREE II: a systematic review

J.J. Pat*, L.P.W. Witte, M.G. Steffens, R.W.M. Vernooij, T.A.T. Marcelissen, P. Fuentes, H.A. Garcia-Perdomo, H. Pardo-Hernandez, M.H. Blanker

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Introduction and hypothesis Recommendations for preventing and diagnosing recurrent urinary tract infection (UTI) tend to vary between clinical practice guidelines (CPGs) because of low-quality scientific evidence, potentially leading to practice variation and suboptimal care. We assessed the quality of existing CPGs for recurrent UTI. Methods A systematic search was performed from January 2000 to June 2021 in PubMed and EMBASE for CPGs on recurrent UTI prevention or hospital diagnostics in Dutch, English, and Spanish. Each CPG was assessed by four appraisers in a multidisciplinary review team, using the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) instrument. Results We identified and assessed eight CPGs published between 2013 and 2021. The scope and purpose (mean and standard deviation: 67.3 +/- 21.8) and clarity of presentation (74.8 +/- 17.6) domains scored highly. However, issues with methods, patient participation, conflict of interests, and facilitators and barriers were common and resulted in lower scores for the rigour of development (56.9 +/- 25.9), applicability (19.6 +/- 23.4), stakeholder involvement (50.4 +/- 24.6), and editorial independence (62.1 +/- 23.1) domains. Overall, two CPGs were recommended, three were recommended with modifications, and three were not recommended. Conclusions Significant room for improvement exists in the quality of CPGs for recurrent UTI, with most displaying serious limitations in the stakeholder involvement, rigour of development, and applicability domains. These aspects must be improved to decrease diagnostic and therapeutic uncertainty. Developers could benefit from using checklists and following guidelines when developing de novo CPGs.
Original languageEnglish
Pages (from-to)1059-1070
Number of pages12
JournalInternational Urogynecology Journal
Volume33
Issue number5
Early online date10 Feb 2022
DOIs
Publication statusPublished - May 2022

Keywords

  • AGREE
  • Guideline
  • Recurrent urinary tract infections
  • Review
  • METAANALYSIS
  • PROPHYLAXIS
  • PREVENTION

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