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Practice guidelines on migrants' health: assessment of their quality and reporting.

ABSTRACT: BACKGROUND:Migrants may carry with them communicable and non communicable diseases as they move to the host country. Screening migrants may help in improving their health status and in preventing the spread of infections to the host population. OBJECTIVE:To identify and assess the quality of published practice guidelines addressing migrants' health. METHODS:We included practice guidelines addressing migrants' health at the clinical, public health or health systems levels. We searched Medline, Embase, the National Guideline Clearinghouse and the Canadian Medical Association's Clinical Practice Guidelines Database. Two teams of two reviewers conducted in duplicate and independent manner study selection, data abstraction, assessment of the guideline quality (using the AGREE II instrument), and assessment of the quality of the reporting (using the RIGHT statement). RESULTS:Out of 2732 citations captured by the electronic search, we included 24 eligible practice guidelines, all addressing the level of post-arrival to the host country and published between 2011 and 2017. The majority of guidelines (57%) addressed non-communicable diseases, 95% addressed screening, while 52% addressed prevention and treatment respectively. The majority of the guidelines reported their funding sources. 86% used the GRADE approach as part of the development process. The included guidelines scored high on the majority of the items, and low on the following two domains of the AGREE II instrument: rigor of development and applicability. The mean number of the RIGHT checklist items met by the included guidelines was 27, out of a total of 35. Most of the guidelines were based on systematic reviews (95.6%). A minority of the included guidelines (26%) reported considering the values and preferences of the target populations or the costs and resource implications (30%) in the formulation of recommendations. CONCLUSION:We identified 23 practice guidelines addressing migrants' health, the majority of which addressed screening services. The vast majority of the captured guidelines targeted screening because the population of interest is migrants, meaning that the intention of the guidelines is to deal with additional factors than usual ones, such as prevalence of disease in country of origin, endemic diseases and others. The guidelines suffered limitations on two quality domains (rigor of development and applicability), and have room for improvement of their reporting.

SUBMITTER: Lotfi T

PROVIDER: S-EPMC7204216 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Practice guidelines on migrants' health: assessment of their quality and reporting.

Lotfi Tamara T Itani Mohamad I MI Howeiss Pamela P Kilzar Lama L Rizk Nesrine A NA Akl Elie A EA

Health and quality of life outcomes 20200507 1

BACKGROUND:Migrants may carry with them communicable and non communicable diseases as they move to the host country. Screening migrants may help in improving their health status and in preventing the spread of infections to the host population. OBJECTIVE:To identify and assess the quality of published practice guidelines addressing migrants' health. METHODS:We included practice guidelines addressing migrants' health at the clinical, public health or health systems levels. We searched Medline, Em ...[more]

PMID: 32380997

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Project description:BackgroundHealth practice guidelines (HPGs) are important tools for the translation of evidence into practice. Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist provides guidance on reporting health practice guidelines (HPGs). We assessed the reporting completeness and quality of a set of national (Croatian) and relevant transnational (European) HPGs.MethodsThe national sample included all HPGs published in the official journal of the Croatian Medical Association in 2014-2016. We searched PubMed to identify relevant European guidelines (n = 24). Two independent reviewers assessed the adherence with the items on the RIGHT checklist. Kappa score was used to measure the level of agreement. Frequentist and Bayes statistics Bayes factor (BF10) was used to evaluate the differences between the national and transnational HPGs.ResultsOverall, Croatian and European HPGs adhered to less than 50% of RIGHT checklist items. Croatian HPGs reported a median of 14.0 (95% CI 13.0-15.0) RIGHT reporting items, and European counterparts reported a median of 16.0 (95% CI 14.0-17.2) out of the total of 35 checklist items (Mann Whitney U test, P = 0.048; BF10 = 1.543). European HPGs were better than Croatian HPGs in reporting stakeholder involvement and values and preferences (BF10 = 80.63), as well as describing the implications of costs and resources (BF10 = 55.15). Croatian HPGs better reported HPGs specified aims (BF10 = 16.90), primary intended users (BF10 = 8.70), and sources of funding (BF10 = 122.90). Most insufficiently reported items for both HPG sets were defining the guideline questions and clear outcomes, quality assurance, management of funding and conflicts of interest, and guideline limitations.ConclusionsImportant methodological details are missing from most published HPGs at national and transnational levels. To ensure better quality and adequate use of HPGs, reporting guidelines should be endorsed and used by developers and users alike.

Project description:IntroductionThe American Dental Association (ADA) defines evidence-based dentistry (EBD) as "an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences." Clinical practice guidelines (CPGs) are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. Therefore, ADA CPGs are the most rigorous examples of EBD to inform clinical practice. CPGs should be of the highest level of quality to ensure the appropriateness and timeliness of clinical recommendations.ObjectivesThe aim of this study was to measure the methodological rigor and transparency of the ADA CPGs.MethodsEach ADA CPG was appraised by 4 independent assessors using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Quantitative quality scores were obtained for 6 domains and overall quality. In addition, assessors provided a qualitative analysis by providing comments for each item and an appraisal of the full recommendation.ResultsA quality score of 75% was used as the threshold for high-quality guidelines. Using this metric, 6 of the current 10 current ADA CPGs were considered to be of high quality, 1 was slightly below the quality threshold, and 3 were considered marginal. Even among those evaluated to be high quality in overall assessment, certain domains did not reach the quality threshold of 75%.ConclusionOverall, the ADA CPGs collectively provide high-quality guidance for the clinician. While the AGREE appraisal guidelines have been used in CPG development since 2016, there is still room for improvement in certain domains (i.e., stakeholder involvement, rigor of development, applicability, and editorial independence).Knowledge transfer statementThe results of this study summarize the methodological rigor and transparency of the 10 current ADA clinical practice guidelines. Since adoption of AGREE standards (2016), CPGs have been uniformly of high quality. The quality of older CPGs was somewhat lower but overall deemed acceptable. Thus, ADA CPGs may be used with confidence to inform practitioners of treatment options supported by rigorous evidence-based dentistry standards. However, there is still room for improvement in methodological quality.

Dataset Information

Practice guidelines on migrants' health: assessment of their quality and reporting.

Publications

Practice guidelines on migrants' health: assessment of their quality and reporting.

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