Appraisal of clinical practice guidelines for the management of attention deficit hyperactivity disorder (ADHD) using the AGREE II Instrument: A systematic review

Yasser Sami Amer; Haya Faisal Al-Joudi; Jeremy L Varnham; Fahad A Bashiri; Muddathir Hamad Hamad; Saleh M Al Salehi; Hadeel Fakhri Daghash; Turki Homod Albatti; Saudi ADHD Society

doi:10.1371/journal.pone.0219239

Appraisal of clinical practice guidelines for the management of attention deficit hyperactivity disorder (ADHD) using the AGREE II Instrument: A systematic review

PLoS One. 2019 Jul 5;14(7):e0219239. doi: 10.1371/journal.pone.0219239. eCollection 2019.

Authors

Yasser Sami Amer^{1

2

3

4}, Haya Faisal Al-Joudi⁵, Jeremy L Varnham^{6

7}, Fahad A Bashiri⁸, Muddathir Hamad Hamad⁸, Saleh M Al Salehi⁹, Hadeel Fakhri Daghash¹⁰, Turki Homod Albatti^{6

11}; Saudi ADHD Society

Affiliations

¹ CPG Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia.
² Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia.
³ Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.
⁴ Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt.
⁵ Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
⁶ Saudi ADHD Society, Riyadh, Saudi Arabia.
⁷ School of Psychology, University of East London, London, United Kingdom.
⁸ Division of Neurology, Department of Pediatrics, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
⁹ Child Development Center, King Abdullah Bin Abdulaziz University Hospital, Princess Noura Bint AbdulRahman University, Riyadh, Saudi Arabia.
¹⁰ Ada'a Program, Assistant Deputyship for Hospital Services, Ministry of Health, Riyadh, Saudi Arabia.
¹¹ Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

Abstract

Background and objective: High quality evidence-based clinical practice guidelines (CPGs) have a major impact on the appropriate diagnosis and management and positive outcomes. The evidence-based healthcare for patients with attention deficit hyperactive disorder (ADHD) is challenging. The objective of this study was to appraise the quality of published CPGs for ADHD.

Methods: A systematic review was conducted for ADHD CPGs using CPG databases, DynaMed, PubMed, and Google Scholar. The quality of each included CPG was appraised by three independent appraisers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument.

Results: Six CPGs were critically reviewed. The AGREE II standardized domain scores revealed variation between the quality of these CPGs with the National Institute of Health and Care Excellence (NICE), University of Michigan Health System, and American Academy of Pediatrics CPGs as the top three. Overall, the recommendations for management of ADHD were similar in these CPGs.

Conclusions: Reporting of CPG development is often poorly documented. Guideline development groups should aim to follow the AGREE II criteria to improve the standards and quality of CPGs. The NICE CPG showed the best quality. Embedding the AGREE II appraisal of CPGs in the training and education of healthcare providers is recommended. The protocol for this study was published in PROSPERO (International prospective register of systematic reviews). Link: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017078712 and is additionally available from protocols.io. Link: https://dx.doi.org/10.17504/protocols.io.q27dyhn.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Attention Deficit Disorder with Hyperactivity / therapy*
Databases, Factual
Evidence-Based Practice
Humans
Practice Guidelines as Topic
Practice Patterns, Physicians' / trends*

Grants and funding

This work was supported by Saudi ADHD Society. URL: https://adhd.org.sa/. This is part of a comprehensive project for adaptation of National CPG for ADHD sponsored by the Saudi ADHD Society. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.