gms | German Medical Science

Background: Clinical practice guidelines (CPG) represent an important tool for healthcare quality improvement worldwide. Quality appraisal of published guidelines is a primary step in CPG construction by development or adaptation.

Objectives. As part of a nationwide effort of CPG construction for prostate cancer patient's care, we systematically reviewed and assessed the quality of published guidelines.

Methods: A systematic search of CPG was performed in clinical databases and widely known developers' websites. Evidence and consensus based guidelines published between January 1, 2006 and April 7, 2011 were included. Four independent reviewers evaluated guidelines quality using the German Guideline Evaluation Instrument (DELBI). Assessed guidelines were divided into three categories: highly recommended, recommended with modifications, and not recommended for adaptation according to DELBI score.

Results: Fourteen eligible guidelines in prostate cancer were evaluated. Main publication language was English (71%). A broad range of quality scores was recorded. Guidelines developed by public agencies or nationwide programs had better quality. Best scored domain was 'Clarity and presentation' (Median 43.8%, range 4.2–83.3%) in contrast with 'Applicability' (Median 0%, range 0–75%). Eleven CPG had low scores in 'Rigor of development', three documents were considered with appropriate quality and only one had a high performance in all domains.

Discussion: A wide range of quality scores in published guidelines was registered, and it could be related with the origin and organizational context of each guideline. Only one guideline met the adaptation process requirements. Limitations in guidelines' adaptation in a developing country must be considered.