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Systematic critical appraisal of GRADE recommendations for prostate cancer staging.

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Title: Systematic critical appraisal of GRADE recommendations for prostate cancer staging.
Alternate Title: Revisión sistemática de las recomendaciones GRADE para la estadificación del cáncer de próstata.
Authors: Sáenz, Dayana1,2 dsaenzr@unal.edu.co, Marcela Torres, Ana3, Pardo, Rodrigo3, Donoso, Wilfredo1,2
Source: Biomédica: Revista del Instituto Nacional de Salud. jun2025, Vol. 45 Issue 2, p286-296. 11p.
Subjects: POSITRON emission tomography, TUMOR grading, TUMOR classification, PROSTATE-specific antigen, COMPUTED tomography
Abstract (English): Introduction. Prostate cancer staging is necessary to determine tumor extent. In recent years, new and more accurate imaging modalities that could provide a better framework for patient management have emerged. They are currently incorporated into the prostate cancer guideline recommendations. Clinical practice guidelines are important for implementing clinical research findings and high-quality evidence-based recommendations. Objective. To review and evaluate the quality of evidence underpinning the categorization of prostate cancer staging guidelines using the AGREE II tool. Materials and methods. Systematic searches were performed on the PubMed, BiGG, and Epistemonikos databases. In addition, repositories and clinical practice guidelines websites were hand searched to identify GRADE recommendations for prostate cancer staging published in the last five years. The quality of clinical practice guidelines was assessed using the AGREE II tool. Recommendations and the certainty of evidence were also summarized. Results. Seven guidelines that met the selection criteria were included. A narrative analysis of the staging recommendations and evidence mapping was performed. The AGREE II domain "clarity of presentation" had the highest score (mean = 71.59%), whereas "applicability" had the lowest score (mean = 45.15%). Five guidelines met the proposed AGREE II cutoff scores and provided staging and diagnostic recommendations. Conclusions. Significant heterogeneity was observed in the methodological quality of the guidelines included, along with common deficits regarding applicability and stakeholder involvement. Thus, more rigorous and high-quality guidelines need to be developed to facilitate their implementation by clinicians in daily practice. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción. La estadificación del cáncer de próstata es necesaria para determinar la extensión tumoral. En los últimos años, han surgido modalidades de imagen nuevas y más precisas que han mejorado el manejo de los pacientes. Las guías de práctica clínica son una herramienta importante para implementar los hallazgos de la investigación clínica basada en evidencia de alta calidad. Objetivo. Revisar y evaluar la calidad de la evidencia de las guías de estadificación del cáncer de próstata mediante la herramienta AGREE II. Materiales y métodos. Se realizó una búsqueda sistemática en las bases de datos PubMed, BiGG y Epistemonikos. También, se exploraron repositorios y sitios web de guías de práctica clínica para identificar recomendaciones GRADE de estadificación del cáncer de próstata publicadas en los últimos cinco años. La calidad metodológica de las guías se evaluó utilizando la herramienta AGREE II. Se resumieron las recomendaciones y la certeza de la evidencia. Resultados. Siete guías cumplieron con los criterios de inclusión. Se hizo un análisis narrativo de las recomendaciones y un mapeo de la evidencia. El dominio "claridad de presentación" tuvo la puntuación más alta (media = 71,59 %), mientras que "aplicabilidad" tuvo la puntuación más baja (media = 45,15 %). Cinco guías cumplieron con el punto corte propuesto y contenían recomendaciones de estadificación y diagnóstico. Conclusiones. Se observó una heterogeneidad significativa en la calidad metodológica de las guías incluidas; se encontraron falencias comunes relacionadas con la aplicabilidad y la participación de las partes interesadas. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Introduction. Prostate cancer staging is necessary to determine tumor extent. In recent years, new and more accurate imaging modalities that could provide a better framework for patient management have emerged. They are currently incorporated into the prostate cancer guideline recommendations. Clinical practice guidelines are important for implementing clinical research findings and high-quality evidence-based recommendations. Objective. To review and evaluate the quality of evidence underpinning the categorization of prostate cancer staging guidelines using the AGREE II tool. Materials and methods. Systematic searches were performed on the PubMed, BiGG, and Epistemonikos databases. In addition, repositories and clinical practice guidelines websites were hand searched to identify GRADE recommendations for prostate cancer staging published in the last five years. The quality of clinical practice guidelines was assessed using the AGREE II tool. Recommendations and the certainty of evidence were also summarized. Results. Seven guidelines that met the selection criteria were included. A narrative analysis of the staging recommendations and evidence mapping was performed. The AGREE II domain "clarity of presentation" had the highest score (mean = 71.59%), whereas "applicability" had the lowest score (mean = 45.15%). Five guidelines met the proposed AGREE II cutoff scores and provided staging and diagnostic recommendations. Conclusions. Significant heterogeneity was observed in the methodological quality of the guidelines included, along with common deficits regarding applicability and stakeholder involvement. Thus, more rigorous and high-quality guidelines need to be developed to facilitate their implementation by clinicians in daily practice. [ABSTRACT FROM AUTHOR]
ISSN:01204157
DOI:10.7705/biomedica.7653