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Clinical Oral Investigations

Published in:

01-05-2019 | Original Article

Screening and diagnosis of oral cancer: a critical quality appraisal of clinical guidelines

Authors: Meisser Madera, Juan Franco, Ivan Solà, Xavier Bonfill, Pablo Alonso-Coello

Published in: Clinical Oral Investigations | Issue 5/2019

Abstract

Objectives

To assess the quality of clinical practice guidelines (CPGs) on screening and diagnosis of oral cancer and to describe the characteristics of their recommendations.

Materials and methods

We systematically searched EMBASE, MEDLINE, CPG’ websites, and dentistry and oncology scientific societies to identify CPGs that were related to screening and diagnosis of oral cancer. The quality of selected CPGs was independently assessed by four appraisers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The inter-appraiser agreement was assessed. We performed a descriptive analysis of the recommendations included in the selected CPGs.

Results

Eight CPGs were selected. The overall agreement among reviewers was considered very good (ICC: 0.823; 95% CI: 0.777–0.861). The median scores of the six AGREE II domains were as follows: “scope and purpose” 97.9% (IQR: 96.2–100.0%); “stakeholder involvement” 86.1% (IQR: 69.8–93.1%); “rigor of development” 75.3% (IQR: 64.2–94.3%); “clarity of presentation” 91.7% (IQR: 82.6–94.4%); “applicability” 53.1% (IQR: 19.3–74.2%); and “editorial independence” 83.3% (IQR: 67.2–93.8%). Four CPGs were assessed as “recommended”, four “recommended with modifications”, and none “not recommended”. Twenty-three recommendations were provided, mostly with a low or very low level of evidence.

Conclusion

The methodological quality of CPGs on screening and diagnosis of oral cancer is moderate. The “applicability” domain scored the lowest. Most recommendations were based on a low o very low level of evidence.

Clinical relevance

Greater efforts are needed to provide healthcare based on high-quality evidence-based CPGs in this field.

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Title: Screening and diagnosis of oral cancer: a critical quality appraisal of clinical guidelines
Authors: Meisser Madera
Juan Franco
Ivan Solà
Xavier Bonfill
Pablo Alonso-Coello
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 5/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2668-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Screening and diagnosis of oral cancer: a critical quality appraisal of clinical guidelines

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

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