Methodological quality of national guidelines for pediatric inpatient conditions.

TitleMethodological quality of national guidelines for pediatric inpatient conditions.
Publication TypeJournal Article
Year of Publication2014
AuthorsHester G, Nelson KE, Mahant S, Eresuma E, Keren R, Srivastava R
JournalJ Hosp Med
Date Published2014 Jun
KeywordsHospitals, Pediatric, Humans, Practice Guidelines as Topic, Quality of Health Care, United States

BACKGROUND: Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children's hospitals. The methodological quality of guidelines for priority conditions is unknown.

OBJECTIVE: To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions.

DESIGN: We searched sources including PubMed for national guidelines published from 2002 to 2012. Guidelines specific to 1 organism, test or treatment, or institution were excluded. Guidelines were rated by 2 raters using a validated tool (Appraisal of Guidelines for Research and Evaluation) with an overall rating on a 7-point scale (7 = the highest). Inter-rater reliability was measured with a weighted kappa coefficient.

RESULTS: Seventeen guidelines met inclusion criteria for 13 conditions; 7 conditions yielded no relevant national guidelines. The highest methodological-quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5, and 6.5, respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3, respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78-0.87).

CONCLUSIONS: We identified a group of moderate to high methodological-quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives.

Alternate JournalJ Hosp Med
PubMed ID24677729
PubMed Central IDPMC4043870
Grant List8UL1TR000105 / TR / NCATS NIH HHS / United States
UL1 TR000105 / TR / NCATS NIH HHS / United States
UL1RR025764 / RR / NCRR NIH HHS / United States