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Quality in aesthetic medicine and surgery: a systematic review of clinical practice guidelines.

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Title: Quality in aesthetic medicine and surgery: a systematic review of clinical practice guidelines.
Alternate Title: Calidad en medicina y cirugía estética: revisión sistemática de las guías de práctica clínica.
Authors: Maes-Carballo, Marta1 marta.maes.md@gmail.com, Estrada-López, Carlos Roberto2, Martínez-Martínez, Carmen2, Alberca-Remigio, Claudia2, Cámara-Martínez, Cristina3, Miguel Josa-Martínez, Benito4, Trigueros, Rubén5
Source: Colombia Medica. 6/30/2024, Vol. 55 Issue 2, p1-14. 14p.
Subjects: MEDICAL protocols, MEDICAL information storage & retrieval systems, CONSENSUS (Social sciences), AESTHETICS, MEDICAL quality control, DECISION making, SYSTEMATIC reviews, MEDLINE, MEDICAL databases
Abstract (English): Background: Guidelines in medicine are essential tools to provide quality and standardised medical care. We analysed the quality of aesthetic medicine guidelines. Methods: A systematic review with a prospective registration protocol (https://osf.io/8pdyv) of databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR), web pages of scientific societies and grey literature was done from inception to February 2023 and without language restrictions. Quality was evaluated using AGREE II (% of the maximum score), RIGHT (% of the total 35 items) and a shared decision making (SDM) quality assessment tool (31 items score) individually and in duplicate, respectively. Results: Six (86%) guidelines were classified as not recommended; one (14%) was recommended with modifications, and all were classified as poorly reported (7/7; 100%). The median overall quality was 27% (IQR: 26-43) and 26% (IQR 15-36) for AGREE II and RIGHT, respectively. No document used these tools for its development. SDM appeared superfluity in almost all of the guidelines explored. Conclusions: Aesthetic medicine and surgical guidelines had low quality and must be improved. There is a wide range of improvement, especially in applicability, reporting of evidence, recommendations, conflict of interest, quality control and SDM. These guidelines require a rigorous methodology based on systematic reviews to ensure quality evidence-based recommendations. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Antecedentes: Las guías en medicina son herramientas esenciales para brindar atención médica estandarizada y de calidad. Métodos: Se realizó una revisión sistemática donde analizamos la calidad de las guías de medicina y cirugía estética siguiendo un protocolo de registro prospectivo (https:// osf.io/8pdyv) tras buscar en bases de datos (MEDLINE, EMBASE, Web of Science, Scopus, CDSR), páginas web de sociedades científicas y literatura gris publicadas sin restricciones de idioma y hasta febrero de 2023. La calidad se evaluó utilizando AGREE II (% de la puntuación máxima), RIGHT (% del total de 35 ítems) y una herramienta de evaluación de calidad de la toma de decisiones compartidas (TDC) (puntuación de 31 ítems) individualmente y por duplicado, respectivamente. Resultados: Seis (86%) guías analizadas fueron clasificadas como no recomendadas; una (14%) como recomendada con modificaciones y todas las guías fueron clasificadas como mal informadas (7/7; 100%). La media de la calidad general fue del 27% (IQ 26-43) y del 26% (IQ 15-36) para AGREE II y RIGHT, respectivamente. Ningún documento incluido utilizó estas herramientas para su desarrollo. La TDC apareció de manera superflua en casi todas las guías analizadas. Conclusiones: En suma, las guías sobre medicina y cirugía estética publicadas hasta la fecha son de baja calidad y deben mejorarse, especialmente en aplicabilidad, presentación de la evidencia, recomendaciones, conflicto de intereses, control de calidad y la TDC. Estas directrices requieren de una metodología rigurosa basada en revisiones sistemáticas para garantizar recomendaciones de calidad basadas en la evidencia. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Background: Guidelines in medicine are essential tools to provide quality and standardised medical care. We analysed the quality of aesthetic medicine guidelines. Methods: A systematic review with a prospective registration protocol (https://osf.io/8pdyv) of databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR), web pages of scientific societies and grey literature was done from inception to February 2023 and without language restrictions. Quality was evaluated using AGREE II (% of the maximum score), RIGHT (% of the total 35 items) and a shared decision making (SDM) quality assessment tool (31 items score) individually and in duplicate, respectively. Results: Six (86%) guidelines were classified as not recommended; one (14%) was recommended with modifications, and all were classified as poorly reported (7/7; 100%). The median overall quality was 27% (IQR: 26-43) and 26% (IQR 15-36) for AGREE II and RIGHT, respectively. No document used these tools for its development. SDM appeared superfluity in almost all of the guidelines explored. Conclusions: Aesthetic medicine and surgical guidelines had low quality and must be improved. There is a wide range of improvement, especially in applicability, reporting of evidence, recommendations, conflict of interest, quality control and SDM. These guidelines require a rigorous methodology based on systematic reviews to ensure quality evidence-based recommendations. [ABSTRACT FROM AUTHOR]
ISSN:01208322
DOI:10.25100/cm.v55i2.6257