Quality of the reporting of Brazilian Ministry of Health updated clinical practice guidelines (CPGU) versions: Applying checkUP




Poster session 4 Saturday: Evidence implementation and evaluation


Saturday 16 September 2017 - 12:30 to 14:00


All authors in correct order:

Vasconcelos L1, Kalb Wainberg S1, Molino CDGRC1, Melo DOD2
1 Faculty of Pharmaceutical Sciences, University of Sao Paulo, Brazil
2 Institute of Environmental Sciences, Chemical and Pharmaceutical, Federal University of São Paulo, Brazil
Presenting author and contact person

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Abstract text
Background: The number of Brazilian clinical practice guidelines (CPG) is increasing since the creation of National Committee for Health Technology Incorporation (CONITEC), in December 2011. Recently many Brazilian Ministry of Health (MoH) guidelines have been updated and ddraft versions have been submitted for public consultation.The article CheckUp, published on Jan 2017, brought new information to the guideline evaluation field.

Objectives: To evaluate the quality of reporting of Brazilian CPGUs. As this was first time that CheckUp was applied to Brazilian guidelines, we also discussed its usability.

Methods: Updated version of 2 Brazilian MoH guidelines that were under public consultation were selected: CPGU1 Cystic Fibrosis (CF) Pancreatic Insufficiency and CPGU2 CF Pulmonary Manifestations.
Two reviewers independently answered CheckUp 16 items and discussed answers in teleconferences. As proposed by CheckUp, each item was answered as Yes, No, Unclear and Not Applicable.

Results: All 16 items were considered applicable for 2 CPGUs. Eleven items were answered as NO for both CPGUs (Table 1). Some of those items, are related to methodology, such as items 11 to 13, which are considered of extreme importance for the quality of CPGs. The lack of this information in the CPGU may compromise its credibility. The same for items 8 and 9, which also were answered as NO. Other items related to clarity of information, such as 3 to 5, and 15 to 16, were also answered as NO, considered as relevant to facilitate the understanting of the users of the guides. Answers from 2 reviewers were the same for majority of items, except for items 1 and 2 (table 1). Reviewers considered those items straightforward, but the level of knowledge about MoH update process influenced answers.

Conclusions: Results show huge opportunity to improve draft versions of Brazilian MoH CPGUs with the adoption of CheckUp. Changes related to methodology are essential, even if they are complex to implement. Other simple changes related to clarity, e.g. adoption of a label for recommendations, could represent important improvement, and facilitate the understanding of guideline users.