Article
Reference
Reporting, presentation and wording of recommendations in clinical practice guideline for gout: a systematic analysis
YANG, Nan, et al.
Abstract
OBJECTIVES: We systematically analysed recommendations from gout guidelines as an example, to provide a basis for developing a reporting standard of recommendations in clinical practice guidelines (CPGs). DESIGN: Systematic review without meta-analysis. METHODS:
We systematically searched MEDLINE and all relevant guideline websites (National Institute for Health and Care Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, WHO, Guidelines International Network, DynaMed, UpTodate, Best Practice) from their inception to January 2017 to identify and select gout CPGs. We used search terms such as 'gout', 'hyperuricemia' and 'guideline'. We included the eligible CPGs of gout according to the predefined inclusion and exclusion criteria after screening titles, abstracts and full texts. The characteristics of recommendations reported in the included guidelines were extracted and analysed.
YANG, Nan, et al . Reporting, presentation and wording of recommendations in clinical practice guideline for gout: a systematic analysis. BMJ Open , 2019, vol. 9, no. 1, p. e024315
PMID : 30700479
DOI : 10.1136/bmjopen-2018-024315
Available at:
http://archive-ouverte.unige.ch/unige:125271
Disclaimer: layout of this document may differ from the published version.
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Additional file 2
Supplementary tables
Table 1 The formatting indicators used to highlight the locating words Table 2 the components of recommendations in acute gouty arthritis drugs Table 3 the components of recommendations in chronic gout drugs
Table 4 The preference of wording for recommendations in included 14 guidelines
Table 5 The voice used in writing recommendations in the included 14 guidelines
Table 6 Six most frequently used expressions used in writing
recommendations in the included 14 guidelines
2
Table 1 The formatting indicators used to highlight the locating words
No. Formatting indicators
boldface coloring large font
1 √
2 √
3
4 √
6 √
7
9 √
10 √ √
12
13 √
14 √ √
15 √ √ √
3
Table 2 the components of recommendations in acute gouty arthritis drugs
Components Word counts
No. Drug dosing Target population
Administration route
Therapeutic goal
(outcome)
Line of treatment
Usage Adverse
reaction
Contraindication Timeframe ● ■ ▲
1 ● ■ ▲ ■ ● ▲ 12 12 30
2 ● ■ ▲ ▲ ● ■ ▲ ● ● ■ ▲ ● ■ ▲ ● ● ■ ● ■ 85 57 43
3 ■ ■ ▲ ▲ ■ ■ 73 18
4
5 ● ■ ▲ ● ● ▲ ● ■ ● ■ ▲ ● 365 307 336
6 ● ▲ ● ■ ▲ 29 29 29
7 ● ■ ● ▲ ▲ ● ■ 22 43 35
8 ● ● ● ▲ ● ■ ● ■ ● ▲ ● ■ ▲ 49 33 42
9 ● ▲ ● ▲ ● ■ 15 15 26
10 ● ▲ ● ■ ▲ 43 43 43
12 ● ● ■ ■ ▲ ▲ 28 18 27
13 ● ▲ ▲ ● ■ ▲ ▲ ● ■ ● 89 71 59
14 ● ● ■ ▲ ● 32 18 18
15 ● ■ ▲ ▲ ● ■ ▲ ● ▲ ● ■ 36 49 76
Note: ● colchicine ■ NSAIDs ▲ corticosteroids
NSAIDs: non-steroidal anti-inflammatory drugs
4
Table 3 the components of recommendations in chronic gout drugs
Components Word counts
No. Line of
treatment
Drug dosing Target population
Therapeutic goal
(outcome)
Adverse reaction
Timeframe Contraindication Usage Administration route
● ■ ▲ ★
1 ★ ★ ● 9 10
2
3 ● ▲ ● ▲ 23 23
4 ● ■ ★ ● ■ ★ ■ ● ■ ★ ● ■ ● ★ 70 110 48 5 ● ■ ★ ● ● ■ ★ ● ★ ■ ★ 181 57 38
6 ● ■ ▲ ★ ● ■ ▲ ★ ● ■ ▲ ★ 27 29 29 29
7 ● ■ ▲ ▲ ● ■ 24 24 20
8 ■ ● ■ ● ■ 56 29
9 ● ● ■ ▲ ★ 47 32 32 32
10 ● ■ ▲ ★ 6 15 15 15
12 ● ■ ▲ 34 34 17
13 ● ● ● ■ ▲ ★ ● 36 39 39 39
14
15 ● ■ ● ■ ▲ ★ ■ ▲ ★ ● ■ 71 56 52 52
Note: ● allopurinol ■ febuxostat ▲ benzbromarone ★ probenecid
5
Table 4 The preference of wording for recommendations in included 14 guidelines
No. Use of a modal verb（should, can, may, will, must, etc.）
Use of the verb "be" Use of a notional verb
1 √ √
2 √ √
3 √ √
4 √ √
5 √ √ √
6 √
7 √ √
8 √ √
9 √ √ √
10 √ √
12 √
13 √ √
14 √
15 √ √ √
Total 12 10 6
6
Table 5 The voice used in writing recommendations in the included 14 guidelines
No. Active voice Passive voice
1 √
2 √
3 √
4 √ √
5 √ √
6 √
7 √ √
8 √
9 √ √
10 √ √
12 √
13 √ √
14 √
15 √ √
Total 9 12
7
Table 6 Six most frequently used expressions used in writing recommendations in the included 14 guidelines
No. 1 2 3 4 5 6 7 8 9 10 12 13 14 15 Total
Should be done √ √ √ √ √ √ √ √ √ √ √ √ 12
Can be done √ √ √ √ √ 5
Be + n √ √ √ √ √ √ √ 7
Be + adj √ √ √ √ √ √ √ √ √ 9
Is/are
recommended
√ √ √ √ √ √ 6
Is/are indicated √ √ √ √ √ √ 6
