Factores que influyen en la calidad de las guías de práctica clínica de cáncer de ovario / Factors influencing the quality of clinical practice guidelines in ovarian cancer

Objetivo. Identificar las características de las guías de práctica clínica publicadas para el manejo del cáncer epitelial de ovario que sugieren una buena calidad metodológica. Materiales y métodos. Revisión de la literatura. Se identificaron 25 guías de práctica clínica de cáncer epitelial de ovario en diferentes bases de datos (MEDLINE, Guidelines International Network, National Guidelines Clearinghouse) publicadas entre 2007 a 2014. Se evaluó la calidad de las guías con la herramienta Appraisal of Guidelines Research and Evaluation II. Se realizaron análisis descriptivos y bivariados para evaluar la asociación entre la calidad de las guías y algunas características de las mismas y de sus desarrolladores. Resultados. El 48% de las guías fueron calificadas como de baja calidad. Las sociedades científicas o centros independientes, y la financiación privada o la baja notificación en el origen de la financiación, estuvieron estadísticamente asociados con una menor calidad de las guías de práctica clínica (p<0,01). Las guías desarrolladas por programas nacionales de guías tuvieron una mediana de puntuación consistentemente superior en todos los dominios del Appraisal of Guidelines Research and Evaluation II, siendo significativas las diferencias en la definición de alcance y objetivos, la participación de los grupos de interés, el rigor metodológico en la elaboración y la aplicabilidad al contexto. Conclusiones. Características como la naturaleza del desarrollador y la financiación de la guía son predictores de calidad que deben ser considerados con antelación al uso de las recomendaciones de un documento de referencia (AU)

Objective. To identify the characteristics of the published clinical practice guidelines for the management of epithelial ovarian cancer that suggest a good methodological quality. Material and methods. A literature review was performed on 25 clinical practice guidelines for epithelial ovarian cancer that were identified in different databases (MEDLINE, Guidelines International Network, National Guidelines Clearing house) published between 2007 and 2014. The quality of the guidelines was evaluated using the Appraisal of Guidelines Research and Evaluation II tool. Descriptive and bivariate analyses were performed to assess the association between the quality of the guidelines and of some of their features and their developers. Results. Just under half (48%) of the guidelines were rated as low quality. Scientific societies or independent centres and private funding, or under-reporting the source of funding, were statistically associated with lower quality of clinical practice guidelines (P<.01). The guidelines developed by National Program Guidelines had a median of consistently higher scores in all domains of the Appraisal of Guidelines Research and Evaluation II, with significant differences in the definition of scope and objectives, the participation of stakeholders, the methodological rigour of development, and applicability to the context. Conclusions. Features such as the nature of the developer and funding of the guidelines are predictors of quality that should be taken into account prior to the use of the recommendations of a document (AU)

[Factors influencing the quality of clinical practice guidelines in ovarian cancer]. / Factores que influyen en la calidad de las guías de práctica clínica de cáncer de ovario.

OBJECTIVE: To identify the characteristics of the published clinical practice guidelines for the management of epithelial ovarian cancer that suggest a good methodological quality. MATERIAL AND METHODS: A literature review was performed on 25 clinical practice guidelines for epithelial ovarian cancer that were identified in different databases (MEDLINE, Guidelines International Network, National Guidelines Clearing house) published between 2007 and 2014. The quality of the guidelines was evaluated using the Appraisal of Guidelines Research and Evaluation II tool. Descriptive and bivariate analyses were performed to assess the association between the quality of the guidelines and of some of their features and their developers. RESULTS: Just under half (48%) of the guidelines were rated as low quality. Scientific societies or independent centres and private funding, or under-reporting the source of funding, were statistically associated with lower quality of clinical practice guidelines (P<.01). The guidelines developed by National Program Guidelines had a median of consistently higher scores in all domains of the Appraisal of Guidelines Research and Evaluation II, with significant differences in the definition of scope and objectives, the participation of stakeholders, the methodological rigour of development, and applicability to the context. CONCLUSIONS: Features such as the nature of the developer and funding of the guidelines are predictors of quality that should be taken into account prior to the use of the recommendations of a document.

Comparing in vitro activity of tigecycline by using the disk diffusion test, the manual microdilution method, and the VITEK 2 automated system.

Tigecycline is a broad spectrum antibiotic having activity against multiresistant isolates. In vitro susceptibility testing is difficult to perform with the use of traditional microbiological techniques. The aim of this study was to evaluate the disk diffusion test with three different Mueller-Hinton agar brands, and the Vitek 2 automated system in comparison with the standard broth microdilution method against 200 gram-negative isolates (Escherichia coil, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens and Acinetobacter baumannii). Among Enterobacteriaceae, the Becton Dickinson agar had the lowest rate of minor (32.5%) and major errors (3.8%). No very major errors were found. For A. baumanni, the rate of minor and major errors was lower. A high rate of agreement (94%) was found between the broth microdilution method and the Vitek 2 system. Our results show that there are important differences between agars used for the disk diffusion test, and that Vitek 2 is a valid tool for susceptibility testing in clinical laboratories.