Critical appraisal of tobacco dependence treatment guidelines

BackgroundTobacco use is a leading preventable cause of morbidity and mortality globally. Clinical practice guidelines for the treatment of tobacco use dependence are of varied scope and quality, making it challenging for users to select and apply recommendations.ObjectiveThe study objective is to identify and critically appraise the quality of existing clinical practice guidelines for tobacco cessation.SettingThe study occurred between collaborative academic institutions located in Qatar and New Zealand.MethodsA systematic literature search was performed for the period 2006-2018 through the following databases: PubMed, EMBASE, CINAHL, ISI Web of Science, Scopus, National Guideline Clearing House, Campbell Library, Health System Evidence, Joanna Briggs Institute Evidence-Based Practice Database, Academic Search Complete, ProQuest, PROSPERO, and Google Scholar. Relevant professional societies' and health agencies' websites were also searched. Two reviewers independently extracted and assessed guidelines' quality using Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument.Main outcome measureStandardized domain scores according to the AGREE II instrument.Results7741 hits were identified. After removing duplicates and screening, 24 guidelines were included. Highest guideline quality was for National Institute for Health and Care Excellence (NICE) guideline with an overall ranking score of 87.56% and least quality was for Japanese Circulation Society Joint Working Group with an overall score of 29.34%. Domain 4 of AGREE II (clarity of presentation) had the highest average quality score (70.95%), while the lowest average quality scores were for Domain 2 (Rigour of Development) (50.21%) and Domain 5 (Applicability) (45.05%).ConclusionSeven guidelines were judged to be of high quality (overall score of >= 70%). Future guidelines for tobacco dependence treatment should use rigorous methods of development and provide applicable recommendations.

Automated summary

Tobacco use is a major preventable cause of morbidity and mortality globally. This study aimed to identify and critically assess the quality of existing clinical practice guidelines for tobacco cessation. The highest quality guideline was from the National Institute for Health and Care Excellence (NICE), while the lowest quality was from the Japanese Circulation Society Joint Working Group. Analysis showed that the clarity of presentation had the highest average quality score, while rigour of development and applicability had the lowest average quality scores.