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Quality assessment of clinical practice guidelines for the prevention and treatment of childhood overweight and obesity

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Abstract

Background

The prevalence of childhood overweight and obesity is increasing at dramatic rates in children and adolescents worldwide. Clinical practice guidelines (CPGs) are “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.” Their objective is to provide explicit recommendations for clinical practice based on current evidence for best practice in the management of diseases.

Materials and methods

The aim of this study was to identify and assess the quality of CPGs for the prevention and treatment of obesity and overweight in childhood. We developed a search to identify CPGs published between January 1998 and August 2007. We considered for inclusion documents that provided recommendations for clinical practice referring to children and adolescents. Three independent appraisers assessed the quality of the1 CPGs using the AGREE (Appraisal of Guidelines Research and Evaluation) instrument. We identified 376 references and selected 22 for further assessment.

Results

The overall agreement among reviewers using the intraclass correlation coefficient was 0.856 (95% confidence interval [CI] 0.731–0.932). Six of the 22 initial guidelines were recommended and a further eight were recommended with conditions or provisos. We concluded that the number of documents with recommendations on the prevention and treatment of childhood obesity published during the 10-year study period was considerable, but only a few of them could be considered as high quality. CPGs were deficient in areas such as applicability, editorial independence and rigor in development.

Conclusion

Due to the increasing burden of obesity among children and the potential for long-term comorbidities, clinicians need to be critical in assessing the rigor of how these are developed and their appropriateness for use in the clinician’s own practice. There is a need to improve the methodology and the quality of CPGs on childhood obesity to help clinicians and other decision-makers to tackle this disease.

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Acknowledgements

We would like to thank Carolyn Newey and Andrés Calvache for their comments and help editing this document.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Cauca, Popayan, Colombia

    Mario Delgado-Noguera

  2. Pediatrics, Obstetrics and Gynecology, and Preventive Medicine Departments, Universidad Autónoma de Barcelona, Barcelona, Spain

    Mario Delgado-Noguera

  3. Iberoamerican Cochrane Center, Clinical Epidemiology and Public Health Department, Hospital de Sant Pau, Barcelona, Spain

    Sera Tort, Xavier Bonfill, Ignasi Gich & Pablo Alonso-Coello

  4. CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    Xavier Bonfill, Ignasi Gich & Pablo Alonso-Coello

  5. Universidad Autónoma de Barcelona, Barcelona, Spain

    Xavier Bonfill & Ignasi Gich

Authors
  1. Mario Delgado-Noguera
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  2. Sera Tort
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  3. Xavier Bonfill
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  4. Ignasi Gich
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  5. Pablo Alonso-Coello
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Corresponding author

Correspondence to Pablo Alonso-Coello.

Additional information

This project was funded with a grant (AE08_015) from CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.

Appendix 1

Appendix 1

The sites searched for the identification of clinical practice guidelines are listed in this appendix.

Generic databases or search engines:

Compiler entities, registries or clearinghouses:

Guidelines developers:

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Delgado-Noguera, M., Tort, S., Bonfill, X. et al. Quality assessment of clinical practice guidelines for the prevention and treatment of childhood overweight and obesity. Eur J Pediatr 168, 789–799 (2009). https://doi.org/10.1007/s00431-008-0836-5

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  • DOI: https://doi.org/10.1007/s00431-008-0836-5

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