National clinical practice guidelines for allergen immunotherapy: An international assessment applying AGREE-II
Background: Since 1988, numerous allergen immunotherapy guidelines (AIT-GLs) have been developed by national and international organizations to guide physicians in AIT. Even so, AIT is still severely underused. Objective To evaluate AIT-GLs with AGREE-II, developed in 2010 by McMaster University met...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2018
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| In: |
Allergy
Year: 2017, Volume: 73, Issue: 3, Pages: 664-672 |
| ISSN: | 1398-9995 |
| DOI: | 10.1111/all.13316 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1111/all.13316 Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/all.13316 
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| Author Notes: | D.E.S. Larenas‐Linnemann, D. Antolín‐Amérigo, C. Parisi, A. Nakonechna, J.A. Luna‐Pech, B. Wedi, I. Davila, M. Gómez, M. Levin, J.A. Ortega Martell, L. Klimek, N. Rosario, A.M. Muraro, I. Agache, J. Bousquet, A. Sheikh, EAACI International Societies Council, O. Pfaar |
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| 245 | 1 | 0 | |a National clinical practice guidelines for allergen immunotherapy |b An international assessment applying AGREE-II |c D.E.S. Larenas‐Linnemann, D. Antolín‐Amérigo, C. Parisi, A. Nakonechna, J.A. Luna‐Pech, B. Wedi, I. Davila, M. Gómez, M. Levin, J.A. Ortega Martell, L. Klimek, N. Rosario, A.M. Muraro, I. Agache, J. Bousquet, A. Sheikh, EAACI International Societies Council, O. Pfaar |
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| 520 | |a Background: Since 1988, numerous allergen immunotherapy guidelines (AIT-GLs) have been developed by national and international organizations to guide physicians in AIT. Even so, AIT is still severely underused. Objective To evaluate AIT-GLs with AGREE-II, developed in 2010 by McMaster University methodologists to comprehensively evaluate GL quality. Methods Allergist, from different continents, knowledgeable in AIT and AGREE-II trained were selected into the project team. The project received methodologists’ guidance. AIT-GLs in any language were sought from 1980 to 2016; AIT-GLs were AGREE II-evaluated by at least 2 team members, independently; discrepancies were resolved in a second round, by team discussion or methodologists’ consulting. Results We found 31 AIT-GLs (15 post-2010), ranging from local consensus reports to international position papers (EAACI, AAAAI-ACAAI, WAO). Pre-2010 GLs scored 1.6-4.6 (23%-67%) and post-2010 GLs scored 2.1-6 (30%-86%), on a 7-point Likert scale. The highest scores went to: German-Austrian-Swiss (6.0), Mexican (5.1), and the AAAAI/ACAAI AIT-GL (4.7). These were also the only 3 GLs that received “yes” of both evaluators to the item: “I would recommend this GL for use.” The domains of “Stakeholder involvement” and “Rigor of Development” only scored 3/7, and “Applicability” scored the lowest. Strikingly, newer GLs only scored clearly better in “Editorial independence” and “Global evaluation.” Conclusions: In AIT-GLs, there is still a lot of room for improvement, especially in domains crucial for the dissemination. For some GLs, the “Scientific rigor” domain flawed. When resources are limited, transculturizing a high-quality GL might be preferable over developing a GL from zero. Our study and AGREE-II could help to select the best candidate. Clinical Implications We here evaluate allergen immunotherapy guideline (AIT-GL) quality. Only high-quality AIT-GLs should be consulted for AIT management decisions. In low-resource settings, transculturization of these is preferred over developing low-quality guidelines. | ||
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