TY - JOUR PY - 2021// TI - Critical appraisal of Paralyzed Veterans of America Guidelines in Spinal Cord Injury: an international collaborative study using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II) JO - Military medicine A1 - Liang, Ning A1 - Wu, Sizhan A1 - Roberts, Simon A1 - Makaram, Navnit A1 - Ngwayi, James Reeves Mbori A1 - Porter, Daniel Edward SP - ePub EP - ePub VL - ePub IS - ePub N2 - INTRODUCTION: Spinal cord injuries (SCI) in military personnel, veterans, and others require an evidence-based, multidisciplinary approach to their care. This appraisal used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to evaluate the methodological quality of clinical guidelines for the management of SCI published by the Paralyzed Veterans of America (PVA) organization.

MATERIALS AND METHODS: We searched clinical guidelines on SCI published by PVA until December 2019. Four appraisers across three international centers independently evaluated the quality of eligible clinical guidelines using AGREE II. Mean AGREE II scores for each domain were calculated. In higher quality domains, scores for individual items were analyzed.

RESULTS: A total of 12 guidelines published by PVA on SCI were assessed. Mean scores for all six domains were as follows: Scope and Purpose (78.8%), Stakeholder Involvement (63.7%), Rigor of Development (68.4%), Clarity of Presentation (80.1%), Applicability (53.0%), and Editorial Independence (28.5%). The mean score for the overall quality of all PVA guidelines was 71.9% (95% CI: 69.7-74.1). No guideline was assessed as "not recommended" by any appraiser. Overall quality was significantly associated with year of publication (rs = 0.754, P = 0.0046). Overall agreement among appraisers was excellent (intraclass correlation coefficients for each guideline ranged from 0.96 to 0.99).

CONCLUSIONS: PVA guidelines for the management of SCI demonstrated acceptable or good quality across most domains. We recommend the use of PVA guidelines for the assessment and treatment of SCI and related disorders. The quality of PVA guidelines for the management of SCI have improved over time.

Language: en

LA - en SN - 0026-4075 UR - http://dx.doi.org/10.1093/milmed/usab465 ID - ref1 ER -