Quality assessment of clinical practice guidelines for neonatal sepsis using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument: A systematic review of neonatal guidelines

Yasser S Amer; Lana A Shaiba; Adnan Hadid; Jasim Anabrees; Abdulrahman Almehery; Manal AAssiri; Abdulrahman Alnemri; Amira R Al Darwish; Badi Baqawi; Ahmad Aboshaiqah; Layal Hneiny; Rana H Almaghrabi; Ahmed M El-Malky; Nawaf M Al-Dajani

doi:10.3389/fped.2022.891572

Quality assessment of clinical practice guidelines for neonatal sepsis using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument: A systematic review of neonatal guidelines

Front Pediatr. 2022 Aug 16:10:891572. doi: 10.3389/fped.2022.891572. eCollection 2022.

Authors

Yasser S Amer^{1

2

3

4

5}, Lana A Shaiba^{6

7}, Adnan Hadid^{6

7}, Jasim Anabrees^{6

7

8}, Abdulrahman Almehery⁹, Manal AAssiri¹⁰, Abdulrahman Alnemri^{6

7

8}, Amira R Al Darwish^{11

12}, Badi Baqawi¹³, Ahmad Aboshaiqah¹⁴, Layal Hneiny^{15

16}, Rana H Almaghrabi¹⁷, Ahmed M El-Malky^{18

19}, Nawaf M Al-Dajani²⁰

Affiliations

¹ Pediatrics Department, King Khalid University Hospital, Riyadh, Saudi Arabia.
² Clinical Practice Guidelines and Quality Research Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia.
³ Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia.
⁴ Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt.
⁵ Adaptation Working Group, Guidelines International Network, Perth, Scotland.
⁶ Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁷ Neonatal Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia.
⁸ Saudi Neonatology Society (SNS), Riyadh, Saudi Arabia.
⁹ Neonatology Department, Ministry of Health, Assir, Saudi Arabia.
¹⁰ Neonatology Department, King Abdulaziz Hospital, Ministry of Health, Jeddah, Saudi Arabia.
¹¹ Clinical Pharmacy Department, Pharmacy Services, Second Health Cluster in Central Region, Riyadh, Saudi Arabia.
¹² Pharmacy Department, King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia.
¹³ Obstetrics and Gynecology Department, King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia.
¹⁴ College of Nursing, King Saud University, Riyadh, Saudi Arabia.
¹⁵ Saab Medical Library, University Libraries, American University of Beirut, Beirut, Lebanon.
¹⁶ Wegner Health Sciences Library, University of South Dakota, Sioux Falls, SD, United States.
¹⁷ Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
¹⁸ Morbidity and Mortality Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
¹⁹ Public Health and Community Medicine Department, Theodor Bilharz Research Institute (TBRI), Academy of Scientific Research, Cairo, Egypt.
²⁰ Neonatal Intensive Care Unit, Infectious Diseases Unit, Pediatrics Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Abstract

Background and objective: Neonatal sepsis (NS) continues to be a critical healthcare priority for the coming decades worldwide. The aim of this study was to critically appraise the quality of recent clinical practice guidelines (CPGs) for neonatal sepsis and to summarize and compare their recommendations.

Methods: This study involves a systematic review of CPGs. We identified clinical questions and eligibility criteria and searched and screened for CPGs using bibliographic and CPG databases and professional societies. Each included CPG was assessed by four independent appraisers using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) instrument. We summarized the recommendations in a comparison practical table. The systematic review was drafted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Its protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42021258732).

Results: Our search retrieved 4,432 citations; of which five CPGs were eligible and appraised: American Academy of Pediatrics (AAP 2018) (35 and 34 weeks); Canadian Pediatric Society (CPS 2017); National Institute for Health and Care Excellence (NICE 2021); and Queensland Maternity and Neonatal Services (QH 2020). Among these, the overall assessment of two evidence-based CPGs scored > 70% (NICE and QH), which was consistent with their higher scores in the six domains of the AGREE II instrument. In domain 3 (rigor of development), NICE and QH scored 99 and 60%, respectively. In domain 5 (applicability), they scored 96 and 74%, respectively, and in domain 6 (editorial independence), they scored 90 and 71%, respectively.

Conclusion: The methodological quality of the NICE CPG was superior followed by the QH CPG with relevant recommendations for use in practice.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021258732, PROSPERO (CRD42021258732).

Keywords: AGREE II instrument; clinical practice guidelines; neonatal sepsis; pediatrics; quality assessment; systematic review.

Publication types

Systematic Review