Open Journal of Obstetrics and Gynecology | 2019
Quality Appraisal of Clinical Guidelines in Obstetrics and Gynecology in India
Abstract
Background: Clinical practice guidelines are important for \nstandard of care. This study was undertaken to assess the quality of Obstetrics \nand Gynecology guidelines in India. Objective Systematic appraisal of clinical \npractice guidelines (CPG) in obstetrics and gynecology in India uses Appraisal of Guidelines \nfor Research and Evaluation II (AGREE II) instrument. Methods: All reported Indian guidelines in obstetrics and \ngynecology from 1st Jan. 2000 \nto 1st April 2018 were identified and subjected to inclusion using 3-point assessment \ncriteria (relevance, clarity of intervention/outcome, and appropriate use of \nhealthcare resources) using WHO AGREE-II instrument. Separate scores for the mean item, domain, and standardized were calculated by \naveraging the scores across two appraisers. Results & Discussion: Of 47 Clinical Practice Guidelines in Obstetrics \nand Gynecology (CPG) from India, 8 met the inclusion criteria. These were \nassessed using AGREE II checklist. \nOverall scores ranged from 8% to 22% (median 5%). No guideline received “Yes” for clinical use by either of the appraisers. Scores for scope and \npurpose and clarity were high but were very low for all the other domains. Only \n1 review had identified cost as one of the focus areas as part of the guideline. Conclusion: Though being clinically \nrelevant the clinical practice guidelines related to obstetrics and gynecology \nin India score poorly. There is a need for \nsensitization and capacity building of clinicians and public health \nprofessionals on the development of CPG related to obstetrics and gynecology in \nIndia.