Methodological assessment of Mexican Clinical Practice Guidelines:
Critical appraisal and GRADE framework adherence.
Abstract
Background and Objective Clinical Practice Guidelines (CPGs) provide
evidence-based recommendations to healthcare professionals, policy
makers, patients and other stakeholders. Mexico is the biggest producer
of CPGs in Latin America and Caribbean countries. The National
Healthcare Technology Excellence Center (acronym in Spanish: CENETEC) is
responsible for the CPG development, adaptation and update. The aim of
this study was to assess the Mexican CPG quality and adherence to the
GRADE framework. Study design We conducted a descriptive cross-sectional
study of 86 CPGs representing all the CPGs produced by CENETEC between
2015 and 2017 and published in an online database called “Catalogo
Maestro”. We performed quality assessment with the online AGREE II tool
and assessed the reporting on the GRADE framework. Results Of the 86
CPGs, 34 were published in 2015, 21 in 2016 and 31 in 2017. The overall
quality by AGREE II proved a median of 16.6% (Min 16.6%, Max 50%). Of
the 86 CPGs, 25 (29%) used the GRADE framework; adherence to GRADE
standards was, however, inconsistent and generally poor. Conclusion CPGs
produced by CENETEC during this period had a low score by AGREE II
standards and low adherence to the GRADE framework. A concerted
initiative could rapidly improve CENETEC guidelines.