Appraising of the Clinical Practice Guidelines Quality in the Non-Pharmacological Management of Chemotherapy-Induced Febrile Neutropenia; A Review

Abstract

Background: Febrile neutropenia is a common and serious chemotherapy side effect, is associated with increased<br />mortality, morbidity, and treatment expenditures. Several CPGs (Clinical practice guidelines) have been released<br />for managing chemotherapy-induced febrile neutropenia. The aim of this study is Appraisal of the clinical practice<br />Guidelines quality in the management of chemotherapy-induced febrile neutropenia. Methods: A review study with<br />a systematic search of the present CPGs for the management of chemotherapy-induced febrile neutropenia. After<br />screening the CPGs based on eligibility criteria, three CPGs were selected and 5 independent reviewers appraised them<br />for methodological quality by using the AGREE II Instrument. Results: Three CPGs were included; all of them were<br />evidence-based guidelines. The clarity of presentation domain scored the highest and the applicability domain has the<br />lowest score among all domains of AGREE instrument and the rest of domains scored as descending respectively;<br />Scope and purpose, stakeholder involvement, editorial independence, rigor of development. In general, the intra-class<br />correlation coefficient (ICC) scores of all domains were very good according to the Landis and Koch's scale, except<br />the Applicability domain scored as substantial. Conclusions: This study showed the quality of appraised CPGs. Three<br />domains of these CPGs based on the AGREE instrument scored less than other domains and were in relatively unfavorable<br />status: applicability, rigor of development, editorial independence. Given the importance of these domains in guideline<br />implementation, it is necessary to take actions for reducing these defects.