PMID- 30442196 OWN - NLM STAT- MEDLINE DCOM- 20190426 LR - 20240403 IS - 2046-4053 (Electronic) IS - 2046-4053 (Linking) VI - 7 IP - 1 DP - 2018 Nov 15 TI - The quality of clinical practice guidelines for management of pediatric type 2 diabetes mellitus: a systematic review using the AGREE II instrument. PG - 193 LID - 10.1186/s13643-018-0843-1 [doi] LID - 193 AB - AIMS: Pediatric type 2 diabetes mellitus (T2DM) is a relatively new disease with increasing incidence corresponding to the obesity epidemic among youth. It is important for clinicians to have access to high-quality clinical practice guidelines (CPGs) for appropriate management of pediatric patients with T2DM. The objective of this systematic review was to evaluate overall quality of CPGs for the management of pediatric T2DM using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. METHODS: We searched MEDLINE, Embase, CINAHL, Trip, National Guideline Clearinghouse, and grey literature to identify eligible CPGs. We also searched the webpages of national and international diabetes and pediatric organizations globally. We included CPGs from national and international diabetes and pediatric associations that were published as standalone guidelines for T2DM in children and adolescents (2-18 years of age). We also included pediatric and adult guidelines for type 1 diabetes if they included a section addressing T2DM management in children and adolescents. We retrieved the two most recent guidelines from each organization when available to assess change in quality over time. We excluded individual studies and systematic reviews that made treatment recommendations as well as CPGs that were developed for a single institution. RESULTS: We included 21 unique CPGs in this systematic review. Of the included guidelines, 12 were developed or updated between 2012 and 2014. Five of all included CPGs were specific to pediatric populations. The analysis revealed that "Rigour of Development" (mean 45%, SD 28.68) and "Editorial Independence" (mean 45%, SD 35.19) were the lowest scoring domains on the AGREE II for the majority of guidelines, whereas "Clarity of Presentation" was the highest scoring domain (mean 72%, SD 18.89). CONCLUSIONS: Overall, two thirds of the pediatric T2DM guidelines were moderate to low quality and the remaining third ranked higher in quality. Low quality was especially due to the scores for the "Rigour of Development" domain, which directly measures guideline development methodology. It is important that future guidelines and updates of existing guidelines improve the methodology of development and quality of reporting in order to appropriately guide physicians managing children and adolescents with T2DM. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016034187. FAU - Bhatt, Meha AU - Bhatt M AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. FAU - Nahari, Ahmed AU - Nahari A AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. AD - Department of Pediatrics, King Fahad Central Hospital, Jizan, Kingdom of Saudi Arabia. FAU - Wang, Pei-Wen AU - Wang PW AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. FAU - Kearsley, Emily AU - Kearsley E AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. FAU - Falzone, Nicole AU - Falzone N AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. FAU - Chen, Sondra AU - Chen S AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. FAU - Fu, Erin AU - Fu E AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. FAU - Jeyakumar, Yaanu AU - Jeyakumar Y AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. FAU - Zukowski, Justyna AU - Zukowski J AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. FAU - Banfield, Laura AU - Banfield L AD - Health Sciences Library, McMaster University, Hamilton, Ontario, Canada. FAU - Thabane, Lehana AU - Thabane L AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. AD - Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada. AD - Center for Evaluation of Medicines, St Joseph's Healthcare, Hamilton, Ontario, Canada. FAU - Samaan, M Constantine AU - Samaan MC AUID- ORCID: 0000-0002-6403-4715 AD - Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. samaanc@mcmaster.ca. AD - Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. samaanc@mcmaster.ca. AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. samaanc@mcmaster.ca. LA - eng PT - Journal Article PT - Systematic Review DEP - 20181115 PL - England TA - Syst Rev JT - Systematic reviews JID - 101580575 SB - IM MH - Adolescent MH - Child MH - Child, Preschool MH - Diabetes Mellitus, Type 2/*therapy MH - Humans MH - Practice Guidelines as Topic/*standards PMC - PMC6238336 COIS- COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/11/18 06:00 MHDA- 2019/04/27 06:00 PMCR- 2018/11/15 CRDT- 2018/11/17 06:00 PHST- 2017/09/05 00:00 [received] PHST- 2018/10/17 00:00 [accepted] PHST- 2018/11/17 06:00 [entrez] PHST- 2018/11/18 06:00 [pubmed] PHST- 2019/04/27 06:00 [medline] PHST- 2018/11/15 00:00 [pmc-release] AID - 10.1186/s13643-018-0843-1 [pii] AID - 843 [pii] AID - 10.1186/s13643-018-0843-1 [doi] PST - epublish SO - Syst Rev. 2018 Nov 15;7(1):193. doi: 10.1186/s13643-018-0843-1.