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Guidelines for the symptomatic management of fever in children: systematic review of the literature and quality appraisal with AGREE II
  1. Elena Chiappini,
  2. Barbara Bortone,
  3. Luisa Galli,
  4. Maurizio de Martino
  1. Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
  1. Correspondence to Dr Elena Chiappini; elena.chiappini{at}unifi.it

Abstract

Introduction Several societies have produced and disseminated clinical practice guidelines (CPGs) for the symptomatic management of fever in children. However, to date, the quality of such guidelines has not been appraised.

Objective To identify and evaluate guidelines for the symptomatic management of fever in children.

Methods The research was conducted using PubMed, guideline websites, and Google (January 2010 to July 2016). The quality of the CPGs was independently assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, and specific recommendations in guidelines were summarised and evaluated. Domain scores were considered of sufficient quality when >60% and of good quality when >80%.

Results Seven guidelines were retrieved. The median score for the scope and purpose domain was 85.3% (range 66.6–100%). The median score for the stakeholder involvement domain was 57.5% (range 33.3–83.3%) and four guidelines scored >60%. The median score for the rigour of development domain was 52.0% (range 14.6–98.9%), and only three guidelines scored >60%. The median score for the clarity of presentation domain was 80.9% (range 50.0–94.4%). The median score for the applicability domain was 39.3% (8.3–100%). Only one guideline scored >60%. The median score for the editorial independence domain was 48.84% (0–91.6%); only three guidelines scored >60%.

Conclusion Most guidelines were recommended for use even if with modification, especially in the methodology, the applicability and the editorial independence domains. Our results could help improve reporting of future guidelines, and affect the selection and use of guidelines in clinical practice.

  • Children
  • guidelines
  • antipyretics
  • fever

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors EC conceptualised and designed the study, used AGREE II instrument to evaluate the retrieved guidelines, drafted the initial manuscript, and approved the final manuscript as submitted. BB carried out the initial analysis, used AGREE II instrument to evaluate the retrieved guidelines, drafted the initial manuscript, and approved the final manuscript as submitted. LG critically reviewed the manuscript, and approved the final manuscript as submitted. MdM critically reviewed the manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Competing interests None declared.

  • Patient consent The study does not includes patient data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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