European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
A systematic evaluation of clinical practice guidelines for the treatment and management of vestibular schwannoma.
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Khan Najm S, Shave Samantha M, Alegun Josephine, Kuriakose Jonathan P, Wackym Phillip Ashley, Shapiro Scott B
Аннотация
OBJECTIVE: Systematically appraise the quality of clinical practice guidelines (CPGs) for vestibular schwannoma treatment and management by utilizing the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.
METHODS: A systematic search of CPGs for the treatment and management of vestibular schwannoma was conducted. MEDLINE (PubMed), EMBASE, and Scopus were queried from inception to January 2023. Inclusion criteria was national and international guidelines or consensus statements. Data was extracted from included articles and four reviewers independently evaluated guidelines in the 6 domains of the AGREE II tool. A domain score was generated with a satisfactory threshold being ≥ 60%.
RESULTS: 785 articles were screened with 9 CPGs selected for evaluation. Three CPGs were found to be "high" quality, five "average" quality, and one "low" quality. CPGs overall scored highest in the "Scope and Purpose" (domain score: 93.67 ± 7.58) and "Clarity and Presentation" (89.04 ± 13.13), while "Applicability" (40.86 ± 25.27) and "Stakeholder Involvement" (57.56 ± 22.08) had the lowest scores. The level of agreement between reviewers was high, with intraclass correlation coefficients ranging from 0.91-0.98 across domains.
CONCLUSION: This appraisal demonstrated an average to high quality for most CPGs regarding vestibular schwannoma treatment and management. While these findings suggest most CPGs are at least average quality, there are opportunities for improvement in several aspects, particularly in domains of applicability, clarifying of conflicts of interest, strength of methodology, and stakeholder involvement.
METHODS: A systematic search of CPGs for the treatment and management of vestibular schwannoma was conducted. MEDLINE (PubMed), EMBASE, and Scopus were queried from inception to January 2023. Inclusion criteria was national and international guidelines or consensus statements. Data was extracted from included articles and four reviewers independently evaluated guidelines in the 6 domains of the AGREE II tool. A domain score was generated with a satisfactory threshold being ≥ 60%.
RESULTS: 785 articles were screened with 9 CPGs selected for evaluation. Three CPGs were found to be "high" quality, five "average" quality, and one "low" quality. CPGs overall scored highest in the "Scope and Purpose" (domain score: 93.67 ± 7.58) and "Clarity and Presentation" (89.04 ± 13.13), while "Applicability" (40.86 ± 25.27) and "Stakeholder Involvement" (57.56 ± 22.08) had the lowest scores. The level of agreement between reviewers was high, with intraclass correlation coefficients ranging from 0.91-0.98 across domains.
CONCLUSION: This appraisal demonstrated an average to high quality for most CPGs regarding vestibular schwannoma treatment and management. While these findings suggest most CPGs are at least average quality, there are opportunities for improvement in several aspects, particularly in domains of applicability, clarifying of conflicts of interest, strength of methodology, and stakeholder involvement.