Modifications to the NEATS instrument for more appropriate and reproducible assessment of guidelines trustworthiness

Maryam Ghadimi, Gordon Guyatt, Romina Brignardello-Petersen
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Abstract

Rational

The National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) instrument measures the adherence of clinical practice guidelines to the trustworthiness standards proposed by the Institute of Medicine. However, rather than trustworthiness or methodological quality, the NEATS instrument evaluates the quality of reporting in addressing the management of conflict of interest of guideline development group members, systematic review process and assessment of the certainty of the evidence, rating the strength of recommendations, and updating plans. Furthermore, the NEATS instrument instructions on rating items are sufficiently limited that they may compromise the reproducibility of the instrument.

Methods (Modifications to the NEATS Instrument)

In the context of a specific methodological research project, we developed modifications to the NEATS instrument that include modifying the wording of items to capture trustworthiness rather than reporting quality and creating an algorithm for all items that maps responses to a series of prompting questions and guides the user in arriving at a rating from 1 to 5 or yes, no, or unknown, as applicable.

Implications

Modifications to the NEATS instrument present a structured and practical framework to assess the degree to which clinical practice guidelines are trustworthy, and they ensure that items evaluate trustworthiness and improve the reproducibility of assessments across a range of raters' level of expertise in guideline methodology.

Abstract Image

修改 NEATS 工具,以更恰当、更可重复地评估指南的可信度
国家指南信息交换所可信标准遵守程度(NEATS)工具可衡量临床实践指南对医学研究所提出的可信标准的遵守程度。不过,NEATS 工具评估的不是可信度或方法学质量,而是在处理指南制定小组成员利益冲突管理、系统回顾过程和证据确定性评估、建议强度评级以及更新计划等方面的报告质量。此外,NEATS 工具中关于评分项目的说明非常有限,可能会影响工具的可重复性。在一个特定的方法学研究项目中,我们对 NEATS 工具进行了修改,包括修改项目措辞以反映可信度而非报告质量,并为所有项目创建了一种算法,该算法可将回答映射到一系列提示问题,并指导用户根据情况从 1 到 5 或 "是"、"否 "或 "未知 "中得出评分。对 NEATS 工具的修改为评估临床实践指南的可信赖程度提供了一个结构化的实用框架,并确保了各项目对可信赖程度的评估,提高了不同评级者在指南方法论方面专业知识水平的评估可重复性。
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