TITLE:
Quality Appraisal of Clinical Guidelines in Obstetrics and Gynecology in India
AUTHORS:
A. G. Radhika, Denny John
KEYWORDS:
Quality Improvement, Implementation, Healthcare, Evidence-Based Practice, AGREE II Tool
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.10,
October
25,
2019
ABSTRACT: Background: Clinical practice guidelines are important for
standard of care. This study was undertaken to assess the quality of Obstetrics
and Gynecology guidelines in India. Objective Systematic appraisal of clinical
practice guidelines (CPG) in obstetrics and gynecology in India uses Appraisal of Guidelines
for Research and Evaluation II (AGREE II) instrument. Methods: All reported Indian guidelines in obstetrics and
gynecology from 1st Jan. 2000
to 1st April 2018 were identified and subjected to inclusion using 3-point assessment
criteria (relevance, clarity of intervention/outcome, and appropriate use of
healthcare resources) using WHO AGREE-II instrument. Separate scores for the mean item, domain, and standardized were calculated by
averaging the scores across two appraisers. Results & Discussion: Of 47 Clinical Practice Guidelines in Obstetrics
and Gynecology (CPG) from India, 8 met the inclusion criteria. These were
assessed using AGREE II checklist.
Overall scores ranged from 8% to 22% (median 5%). No guideline received “Yes” for clinical use by either of the appraisers. Scores for scope and
purpose and clarity were high but were very low for all the other domains. Only
1 review had identified cost as one of the focus areas as part of the guideline. Conclusion: Though being clinically
relevant the clinical practice guidelines related to obstetrics and gynecology
in India score poorly. There is a need for
sensitization and capacity building of clinicians and public health
professionals on the development of CPG related to obstetrics and gynecology in
India.