A quality assessment and systematic review of clinical practice guidelines on hormone replacement therapy for menopause using the AGREE II instrument

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-11-02 DOI:10.1016/j.ejogrb.2024.10.046

Maria-Patricia Roman , Răzvan Ciortea , Stergios K. Doumouchtsis , Roxana Din , Andrei Mihai Măluţan , Carmen Elena Bucuri , Elena-Alexandra Căşeriu , Cristina Mihaela Ormindean , Ionel Daniel Nati , Viorela-Elena Suciu , Dan Mihu

{"title":"A quality assessment and systematic review of clinical practice guidelines on hormone replacement therapy for menopause using the AGREE II instrument","authors":"Maria-Patricia Roman , Răzvan Ciortea , Stergios K. Doumouchtsis , Roxana Din , Andrei Mihai Măluţan , Carmen Elena Bucuri , Elena-Alexandra Căşeriu , Cristina Mihaela Ormindean , Ionel Daniel Nati , Viorela-Elena Suciu , Dan Mihu","doi":"10.1016/j.ejogrb.2024.10.046","DOIUrl":null,"url":null,"abstract":"<div><div>Clinical Practice Guidelines (CPGs) have an indispensable role in guiding the selection of treatments for menopause. Variations in guidelines can impact treatments and health outcomes. The aim of this study was to assess CPGs on hormone replacement therapy (HRT) for menopause, systematically reviewing their quality and compiling recommendations for HRT usage.</div><div>Embase, Scopus, MedLine, Geneva Foundation for Medical Education and Research databases were searched to identify relevant publications. CPGs published in English language, focusing specifically on HRT for menopause were included in the analysis. Four reviewers assessed the quality of the included CPGs using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument and compiled congruent as well as contradictory recommendations.</div><div>Nine guidelines met the inclusion criteria. The National Institute for Health and Care Excellence (NICE), the Endocrine Society and The Association of the Scientific Medical Societies guidelines were deemed to have the highest quality and are recommended without modifications. Out of 300+ extracted recommendations, merely 17 showed consistency, overlapping in at least two CPGs. The recommendations were categorized into three domains: treatment considerations, impact of HRT on non-reproductive organ systems, and the associations of HRT with cancer. The included CPGs exhibited the highest scores in the “Clarity of presentation” and “Scope and purpose” AGREE II domains.</div><div>This study found variation in recommendations and quality of CPG on HRT for menopause. Notably, only a small fraction of recommendations showed consistency across guidelines, highlighting the variability in HRT management. Efforts to improve the quality of CPGs in this area are essential to optimize patient care and outcomes in menopausal women receiving HRT.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 294-301"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of obstetrics, gynecology, and reproductive biology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0301211524005931","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Clinical Practice Guidelines (CPGs) have an indispensable role in guiding the selection of treatments for menopause. Variations in guidelines can impact treatments and health outcomes. The aim of this study was to assess CPGs on hormone replacement therapy (HRT) for menopause, systematically reviewing their quality and compiling recommendations for HRT usage.

Embase, Scopus, MedLine, Geneva Foundation for Medical Education and Research databases were searched to identify relevant publications. CPGs published in English language, focusing specifically on HRT for menopause were included in the analysis. Four reviewers assessed the quality of the included CPGs using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument and compiled congruent as well as contradictory recommendations.

Nine guidelines met the inclusion criteria. The National Institute for Health and Care Excellence (NICE), the Endocrine Society and The Association of the Scientific Medical Societies guidelines were deemed to have the highest quality and are recommended without modifications. Out of 300+ extracted recommendations, merely 17 showed consistency, overlapping in at least two CPGs. The recommendations were categorized into three domains: treatment considerations, impact of HRT on non-reproductive organ systems, and the associations of HRT with cancer. The included CPGs exhibited the highest scores in the “Clarity of presentation” and “Scope and purpose” AGREE II domains.

This study found variation in recommendations and quality of CPG on HRT for menopause. Notably, only a small fraction of recommendations showed consistency across guidelines, highlighting the variability in HRT management. Efforts to improve the quality of CPGs in this area are essential to optimize patient care and outcomes in menopausal women receiving HRT.

查看原文本刊更多论文

使用 AGREE II 工具对更年期激素替代疗法的临床实践指南进行质量评估和系统回顾。

临床实践指南（CPG）在指导更年期治疗方法的选择方面发挥着不可或缺的作用。指南的不同会影响治疗和健康结果。本研究旨在评估有关更年期激素替代疗法（HRT）的临床实践指南，系统地审查其质量并汇编有关使用 HRT 的建议。研究人员检索了 Embase、Scopus、MedLine 和日内瓦医学教育与研究基金会数据库，以确定相关出版物。以英语发表的、专门针对更年期的 HRT 的 CPG 纳入了分析范围。四位评审员使用研究与评估指南评估 II (AGREE II) 工具对纳入的 CPGs 进行了质量评估，并汇编了一致和矛盾的建议。九项指南符合纳入标准。美国国家健康与护理卓越研究所（NICE）、内分泌学会和科学医学协会的指南被认为质量最高，无需修改即可推荐使用。在提取的 300 多条建议中，仅有 17 条具有一致性，至少在两条 CPG 中重叠。这些建议分为三个领域：治疗注意事项、HRT 对非生殖器官系统的影响以及 HRT 与癌症的关系。纳入的 CPG 在 "表述清晰度 "和 "范围与目的 "AGREE II 领域中得分最高。这项研究发现，有关更年期激素治疗的 CPG 在建议和质量方面存在差异。值得注意的是，只有一小部分建议在不同指南中表现出一致性，这凸显了更年期激素治疗管理的差异性。努力提高该领域 CPG 的质量对于优化接受 HRT 的更年期妇女的患者护理和治疗效果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.