RT Journal Article
SR Electronic
T1 Poor overall quality of clinical practice guidelines for musculoskeletal pain: a systematic review
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 337
OP 343
DO 10.1136/bjsports-2017-098375
VO 52
IS 5
A1 Ivan Lin
A1 Louise K Wiles
A1 Robert Waller
A1 Roger Goucke
A1 Yusuf Nagree
A1 Michael Gibberd
A1 Leon Straker
A1 Christopher G Maher
A1 Peter P B O’Sullivan
YR 2018
UL http://bjsm.bmj.com/content/52/5/337.abstract
AB Objectives Undertake a systematic critical appraisal of contemporary clinical practice guidelines (CPGs) for common musculoskeletal (MSK) pain conditions: spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis) and shoulder.Design Systematic review of CPGs (PROSPERO number: CRD42016051653).Included CPGs were written in English, developed within the last 5 years, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.Data sources and method of appraisal Four scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used for critical appraisal.Results 4664 records were identified, and 34 CPGs were included. Most were for osteoarthritis (n=12) or low back pain (n=11), most commonly from the USA (n=12). The mean overall AGREE II score was 45% (SD=19.7). Lowest mean domain scores were for applicability (26%, SD=19.5) and editorial independence (33%, SD=27.5). The highest score was for scope and purpose (72%, SD=14.3). Only 8 of 34 CPGS were high quality: for osteoarthritis (n=4), low back pain (n=2), neck (n=1) and shoulder pain (n=1).