Systematic appraisal of the guidelines for the diagnosis and treatment of Hirschsprung’s disease
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In brief
In brief
Systematic review of nine Hirschsprung disease clinical guidelines using AGREE II methodology reveals significant quality variation, with only one guideline meeting recommendation standards. Analysis identifies critical gaps in evidence quality and recommendations for diagnosis, staging, and treatment approaches.
Written by the GCMD Library team from the article.
Abstract
Background
Some guidelines for management of Hirschsprung’s disease (HSCR, HD) have been developed, but their quality is vague. This study will systematically assess the quality of guidelines and analyze the key recommendations and the best evidence for guidelines.
Methods
Applicable guidelines were retrieved using a systematic search of databases. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was used to assess the quality of the guidelines. Then, the recommendations and evidence for the included guidelines were extracted and compared.
Results
A total of nine guidelines were included in this study, and only one had an overall standardized score of more than 60%, indicating that it is worthy of recommendation. The problems identified included ambiguous and low-quality evidence; obvious distributional heterogeneity among the recommendations; a lack of in-depth discussion on the interpretation of staging, diagnostic methods, conservative treatment, and surgical staging of disease.
Conclusion
The quality of guidelines varies widely, and there is a lack of high-quality professional opinions and supporting evidence for the main recommendations. At present, only comprehensive guidelines can be considered high-quality and there is still room for improvement.