Level of Evidence of Guidelines for Perioperative Management of Patients With Obstructive Sleep Apnea: An Evaluation Using the Appraisal of Guidelines for Research and Evaluation II Tool
Authors' conclusion
This critical appraisal showed that many clinical practice guidelines for perioperative management of patients with OSA used validated methods to grade medical literature, such as Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and Oxford classification, with lower scores for stakeholder involvement due to lack of engagement of patient partners and applicability domain due to lack of focus on the complete perioperative period such as postdischarge counseling.
Study context
- Population
- Clinical practice guidelines (English) on perioperative management of patients with obstructive sleep apnea (OSA), MedlineALL (Ovid) inception to February 26, 2021guidelines included
- Participants
- 10 guidelines
- Outcome
- Guideline quality: AGREE II domain scores (%)
Methodological detailsAGREE II, PRISMA-compliant, 7 evaluators, 192 articles identified, 41 full texts assessed, 10 included
- AGREE II
- PRISMA-compliant
- 7 evaluators
- 192 articles identified, 41 full texts assessed, 10 included
Pooled result
As reported in the abstract
AGREE II domain scores
- Scope and purpose, median (range)
- 88% (60%-95%)
- Stakeholder involvement, median (range)
- 52% (30%-82%)
- Rigor of development, median (range)
- 67% (40%-90%)
- Clarity of presentation, median (range)
- 74% (57%-88%)
- Applicability, median (range)
- 46% (20%-73%)
- Editorial independence, median (range)
- 67% (19%-83%)
- Guidelines with overall score >70%
- 4
Further pooled results
Interrater consistency
- Intraclass correlation coefficients across 7 evaluators for each guideline
- >0.9
Basis of recommendations
- Recommendations based on evidence graded by validated methods (remainder consensus based)
- Sixty percent
Original publication
Level of Evidence of Guidelines for Perioperative Management of Patients With Obstructive Sleep Apnea: An Evaluation Using the Appraisal of Guidelines for Research and Evaluation II Tool. Anesth Analg. Published 12 December 2022. doi:10.
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