Systematic Analysis and Critical Appraisal of the Quality of the Scientific Evidence and Conflicts of Interest in Practice Guidelines (2005-2013) for Barrett's Esophagus.

{"article_title":"Systematic Analysis and Critical Appraisal of the Quality of the Scientific Evidence and Conflicts of Interest in Practice Guidelines (2005-2013) for Barrett's Esophagus.","author":"Feuerstein JD, Castillo NE, Akbari M, Belkin E, Lewandowski JJ, Hurley CM, Lloyd S, Leffler DA, Cheifetz AS","journal_title":"Digestive diseases and sciences","issn":"1573-2568","isbn":"","publication_date":"2016 Oct","volume":"61","issue":"10","first_page":"2812","page_count":"","accession_number":"27307064","doi":"10.1007\/s10620-016-4222-2","publisher":"Springer Science + Business Media","doctype":"Journal Article","subjects":"Barrett Esophagus therapy; Conflict of Interest; Evidence-Based Medicine; Practice Guidelines as Topic standards; Barrett Esophagus diagnosis; Disease Management; Humans","interest_area":["Oncology"," Gastroenterology"],"abstract":"Background: Barrett's esophagus (BE) is a condition that has a small but important risk of progressing to esophageal cancer. To date, no study has assessed the strength of evidence supporting the recommendations for BE. We sought to assess the overall quality of the recommendations and strength of the BE using the AGREE II instrument. Methods: A PubMed search was performed to identify guidelines published pertaining to BE. Every guideline was reviewed using the AGREE II format to assess the methodological rigor and validity of the guideline. Additionally, guidelines were reviewed for the level of evidence used to support recommendations, conflicts of interest (COI), and differences in recommendations. Statistical analysis was performed using Stata (version 12). Results: In total, 234 manuscripts were identified of which 8 guidelines published between 2005 and 2013 pertained to BE. Seventy-five percentage (6\/8) graded the evidence used to formulate recommendations. Of the 126 recommendations with supporting evidence, 6 % were supported by level A evidence, 49 % level B evidence, and 45 % level C evidence. Using the AGREE II format, the highest overall assessment grade was the BSG BE guideline (6.5 \ufffd 0.6) followed by the AGA (5.5 \ufffd 0.6). The highest rated domains were scope and purpose (mean 77 range 24-96) and clarity of presentation (mean 75), while the lowest rated domains were editorial independence (mean 32 range 0-92) and applicability of the guideline (mean 35 range 7-90). There was significant variability in recommendations regarding who to screen for BE and surveillance intervals. Finally, only 50 % of the guidelines disclosed if COI were present and 75 % (3\/4) reported potentially relevant COI. Conclusions: Majority of the BE guideline fail to meet the AGREE II domains, and most of the recommendations are level B or C quality evidence. Further interventions are necessary to improve the overall quality of the guidelines.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=27307064&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Feuerstein JD, Castillo NE, Akbari M, Belkin E, Lewandowski JJ, Hurley CM, Lloyd S, Leffler DA, Cheifetz AS","Journal_Info":"Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 7902782 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2568 (Electronic) Linking ISSN: 01632116 NLM ISO Abbreviation: Dig Dis Sci Subsets: MEDLINE","Publication_Type":"Journal Article; Review","Published_Date":"2016-10-01","Source":"Digestive diseases and sciences [Dig Dis Sci] 2016 Oct; Vol. 61 (10), pp. 2812-2822. Date of Electronic Publication: 2016 Jun 15.","Languages":"English","Electronic_ISSN":"1573-2568","MeSH_Terms":"Conflict of Interest* , Evidence-Based Medicine*, Barrett Esophagus\/*therapy , Practice Guidelines as Topic\/*standards, Barrett Esophagus\/diagnosis ; Disease Management ; Humans","Subjects":"Barrett Esophagus diagnosis, Disease Management, Humans, Barrett Esophagus therapy, Conflict of Interest, Evidence-Based Medicine, Practice Guidelines as Topic standards","Title_Abbreviations":"Digestive diseases and sciences","Volume":"61"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"27307064","RelevancyScore":"795","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"795.412353515625"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=27307064&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=27307064&authtype=shib&custid=ns346513&group=main&profile=eds"}