http://www.bjj.boneandjoint.org.uk/content/96-B/1/19.abstract

Quality assessment of guidelines on thromboprophylaxis in orthopaedic surgery

1. S. Sabharwal, MBBS, MRCS, MSc, SpR in Trauma and Orthopaedics, North West Thames Rotation and Honorary Surgical Research Fellow 1 ; 
2. S. Gauher, MBBS, BSc, National Medical Director’s Clinical Fellow2;
3. S. Kyriacou, MBBS, MRCS, SpR Trauma and Orthopaedics 3 ; 
4. V. Patel, MBBS, MRCS, Surgical Research Fellow 1; 
5. I. Holloway, FRCS(T&O), Consultant Orthopaedic Surgeon2; and 
6. T. Athanasiou, MD, PhD, FRCS, FETCS, Professor of Cardiovascular Sciences and Cardiac Surgery; Lead of Surgical Quality and Epidemiology1

+Author Affiliations

1. 1Imperial College London, Department of Surgery and Cancer, 10th Floor QEQM building, St Mary’s Hospital, London W2 1NY, UK.
2. 2Northwick Park Hospital, The North West London Hospitals NHS Trust, Watford Road, Harrow HA1 3UJ, UK.
3. 3Imperial College, London, North West Thames Rotation, Department of Surgery and Cancer, 10th Floor QEQM building, St Mary’s Hospital, London W2 1NY, UK.

1. Correspondence should be sent to Mr S. Sabharwal; e-mail:sanjeeve.sabharwal@ic.ac.uk

Abstract

We evaluated the quality of guidelines on thromboprophylaxis in orthopaedic surgery by examining how they adhere to validated methodological standards in their development. A structured review was performed for guidelines that were published between January 2005 and April 2013 in medical journals or on the Internet. A pre-defined computerised search was used in MEDLINE, Scopus and Google to identify the guidelines. The AGREE II assessment tool was used to evaluate the quality of the guidelines in the study.

Seven international and national guidelines were identified. The overall methodological quality of the individual guidelines was good. ‘Scope and Purpose’ (median score 98% interquartile range (IQR)) 86% to 98%) and ‘Clarity of Presentation’ (median score 90%, IQR 90% to 95%) were the two domains that received the highest scores. ‘Applicability’ (median score 68%, IQR 45% to 75%) and ‘Editorial Independence’ (median score 71%, IQR 68% to 75%) had the lowest scores.

These findings reveal that although the overall methodological quality of guidelines on thromboprophylaxis in orthopaedic surgery is good, domains within their development, such as ‘Applicability’ and ‘Editorial Independence’, need to be improved. Application of the AGREE II instrument by the authors of guidelines may improve the quality of future guidelines and provide increased focus on aspects of methodology used in their development that are not robust.

Cite this article: Bone Joint J 2014;96-B:19–23.

Footnotes

• No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
  This article was primary edited by J. Scott and first-proof edited by D. Rowley.

• Received August 1, 2013.
• Accepted October 25, 2013.

• ©2014 The British Editorial Society of Bone & Joint Surgery