Abstract

CALLE, J. L. de la et al. Spinal infusion: a critical assessment of clinical guidelines using the AGREE tool. Rev. Soc. Esp. Dolor [online]. 2011, vol.18, n.3, pp.187-192. ISSN 1134-8046.

Objectives: to identify and to evaluate quality levels in clinical practice guidelines (CPGs) on spinal infusion using the AGREE (Appraisal of Guidelines Research and Evaluation) tool prior to its possible adaptation to and application in our setting. Material and methods: two authors independently performed a systematic literature search for CPGs. Each selected CPG was evaluated by 4 reviewers using the Spanish-adapted AGREE tool. Six assessment areas were examined for each CPG. Finally, according to criteria suggested by Etxeberría and Rotaeche, a definitive global assessment of each CPG was performed based on score standardization for each area. Results: 13 CPGs were selected for evaluation. In the definitive global assessment 7 CPGs were deemed "non-recommended", 5 were deemed "conditionally recommended", and 1 was considered "highly recommended". All 7 non-recommended CPGs remained below the cutoff in all evaluated areas, all 5 conditionally recommended CPGs reached above the cutoff in two areas, and the one highly recommended CPG reached above the cutoff in 4 areas. Conclusions: the quality assessment of existing CPGs on spinal infusion has revealed a wide margin for improvement in most of them. A critical appraisal of CPG quality is crucial before CPG application is encouraged in our setting.

Keywords : Critical assessment; Clinical guidelines; Spinal infusion; Pain management.

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