Determining the methodological rigor and overall quality of out-of-hospital clinical practice guidelines: a scoping review protocol.

Objective: This scoping review will aim to determine the methodological rigor and quality of out-of-hospital clinical practice guidelines (CPGs) by collating and describing all literature that assessed these documents using a structured appraisal instrument.

Introduction: In the out-of-hospital setting, the provision of emergency health care by paramedics and first responders is guided, directed, or informed by localized, overarching CPGs. Numerous CPGs in this setting have been assessed for their methodological rigor and overall quality using an appraisal instrument. However, a summation of the overall standard of guidelines within this space has yet to be described.

Inclusion criteria: This scoping review will consider all primary and secondary peer-reviewed research that has used a structured appraisal instrument to assess the overall quality of CPGs designed specifically for the out-of-hospital setting. Studies that have assessed CPGs designed for in-hospital environments, such as emergency departments, critical care units, or surgical wards, will be excluded.

Methods: This review will follow the JBI methodology for scoping reviews. The following databases and/or information sources will be searched: MEDLINE (Ovid), Embase (Ovid), CINAHL with Full Text (EBSCOhost), Scopus, and ProQuest Central (ProQuest). No publication or language limits will be applied. Study selection and data extraction will be performed independently by 2 reviewers, with any disagreements resolved by discussion or with the involvement of an independent third reviewer. In instances where crucial data cannot be extracted, the corresponding author of the article will be contacted. Data will be analyzed using basic descriptive techniques and will be presented in both tabular and diagrammatic formats, accompanied by a narrative description.

Review registration: Open Science Framework https://osf.io/qvrhw.