Poor overall quality of clinical practice guidelines for musculoskeletal pain: a systematic review

Ivan Lin, Louise K. Wiles, Robert Waller, Roger Goucke, Yusuf Nagree, Michael Gibberd, Leon Straker, Christopher G. Maher, Peter P. B. O'Sullivan

Research output: Contribution to journalReview article

5 Citations (Scopus)
61 Downloads (Pure)

Abstract

Objectives Undertake a systematic critical appraisal of contemporary clinical practice guidelines (CPGs) for common musculoskeletal (MSK) pain conditions: spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis) and shoulder.

Design Systematic review of CPGs (PROSPERO number: CRD42016051653). Included CPGs were written in English, developed within the last 5 years, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.

Data sources and method of appraisal Four scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used for critical appraisal.

Results 4664 records were identified, and 34 CPGs were included. Most were for osteoarthritis (n= 12) or low back pain (n= 11), most commonly from the USA (n= 12). The mean overall AGREE II score was 45% (SD= 19.7). Lowest mean domain scores were for applicability (26%, SD= 19.5) and editorial independence (33%, SD= 27.5). The highest score was for scope and purpose (72%, SD= 14.3). Only 8 of 34 CPGS were high quality: for osteoarthritis (n= 4), low back pain (n= 2), neck (n= 1) and shoulder pain (n= 1).

Original languageEnglish
Pages (from-to)337-+
Number of pages8
JournalBritish Journal of Sports Medicine
Volume52
Issue number5
DOIs
Publication statusPublished - 1 Mar 2018

Cite this

Lin, Ivan ; Wiles, Louise K. ; Waller, Robert ; Goucke, Roger ; Nagree, Yusuf ; Gibberd, Michael ; Straker, Leon ; Maher, Christopher G. ; O'Sullivan, Peter P. B. / Poor overall quality of clinical practice guidelines for musculoskeletal pain : a systematic review. In: British Journal of Sports Medicine. 2018 ; Vol. 52, No. 5. pp. 337-+.
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Poor overall quality of clinical practice guidelines for musculoskeletal pain : a systematic review. / Lin, Ivan; Wiles, Louise K.; Waller, Robert; Goucke, Roger; Nagree, Yusuf; Gibberd, Michael; Straker, Leon; Maher, Christopher G.; O'Sullivan, Peter P. B.

In: British Journal of Sports Medicine, Vol. 52, No. 5, 01.03.2018, p. 337-+.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Poor overall quality of clinical practice guidelines for musculoskeletal pain

T2 - a systematic review

AU - Lin, Ivan

AU - Wiles, Louise K.

AU - Waller, Robert

AU - Goucke, Roger

AU - Nagree, Yusuf

AU - Gibberd, Michael

AU - Straker, Leon

AU - Maher, Christopher G.

AU - O'Sullivan, Peter P. B.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objectives Undertake a systematic critical appraisal of contemporary clinical practice guidelines (CPGs) for common musculoskeletal (MSK) pain conditions: spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis) and shoulder.Design Systematic review of CPGs (PROSPERO number: CRD42016051653). Included CPGs were written in English, developed within the last 5 years, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.Data sources and method of appraisal Four scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used for critical appraisal.Results 4664 records were identified, and 34 CPGs were included. Most were for osteoarthritis (n= 12) or low back pain (n= 11), most commonly from the USA (n= 12). The mean overall AGREE II score was 45% (SD= 19.7). Lowest mean domain scores were for applicability (26%, SD= 19.5) and editorial independence (33%, SD= 27.5). The highest score was for scope and purpose (72%, SD= 14.3). Only 8 of 34 CPGS were high quality: for osteoarthritis (n= 4), low back pain (n= 2), neck (n= 1) and shoulder pain (n= 1).

AB - Objectives Undertake a systematic critical appraisal of contemporary clinical practice guidelines (CPGs) for common musculoskeletal (MSK) pain conditions: spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis) and shoulder.Design Systematic review of CPGs (PROSPERO number: CRD42016051653). Included CPGs were written in English, developed within the last 5 years, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.Data sources and method of appraisal Four scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used for critical appraisal.Results 4664 records were identified, and 34 CPGs were included. Most were for osteoarthritis (n= 12) or low back pain (n= 11), most commonly from the USA (n= 12). The mean overall AGREE II score was 45% (SD= 19.7). Lowest mean domain scores were for applicability (26%, SD= 19.5) and editorial independence (33%, SD= 27.5). The highest score was for scope and purpose (72%, SD= 14.3). Only 8 of 34 CPGS were high quality: for osteoarthritis (n= 4), low back pain (n= 2), neck (n= 1) and shoulder pain (n= 1).

KW - LOW-BACK-PAIN

KW - KNEE OSTEOARTHRITIS

KW - GLOBAL BURDEN

KW - DISEASE 2010

KW - EUROPEAN-SOCIETY

KW - ECONOMIC-ASPECTS

KW - PRIMARY-CARE

KW - OF-INTEREST

KW - NECK PAIN

KW - AGREE II

U2 - 10.1136/bjsports-2017-098375

DO - 10.1136/bjsports-2017-098375

M3 - Review article

VL - 52

SP - 337-+

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

IS - 5

ER -