Introduction
Methods
Data Search
Inclusion and exclusion criteria
Data Collection
Quality assessment
Statistical analysis
Guideline | Country | Organization | Year | Method used to asses quality and strength of evidence |
---|---|---|---|---|
AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis [28] | USA | American Gastroenterological Association (AGA) | 2019 | GRADEa |
ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents [29] | UK | European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) | 2013 | Oxford Centre for Evidence-Based Medicine |
ACG Clinical Guideline: Management of Crohn’s Disease in Adults [30] | USA | American College of Gastroenterology | 2018 | GRADE |
European evidence based consensus on surgery for ulcerative colitis [31] | Multinational | European Crohn’s and Colitis Organization (ECCO) | 2014 | Oxford Center for Evidence-Based Medicine |
Updated German Clinical Practice Guideline on “Diagnosis and treatment of Crohn’s disease” 2014 [32] | Germany | German Society for gastroenterology, digestive and metabolic diseases (DGVS) with the participation of Deutsche Gesellschaft for General and Visceral Surgery (DGAV), German Society of Surgery (DGCh), German Society for Internal Medicine (DGIM), German Society for Coloproctology (DGK), German Morbus Crohn’s / ulcerative colitis association (DCCV), Society for pediatric gastroenterology and nutrition (GPGE), Competence Network for Inflammatory Bowel Diseases. | 2014 | Oxford Center for Evidence-Based Medicine |
Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease [33] | Multinational | European Crohn’s and Colitis Organization (ECCO / ESPGHAN) | 2014 | Oxford Center for Evidence-Based Medicine |
Management of paediatric ulcerative colitis, Part 1: ambulatory care- an evidence-based guideline from ECCO and ESPGHAN [34] | Israel | Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel. | 2018 | Oxford Centre for Evidence-Based Medicine |
Evidence-based clinical practice guidelines for Crohn’s disease, integrated with formal consensus of experts in Japan [35] | Japan | Japanese Society of Gastroenterology and the Research group of Intractable Bowel Disease subsidized by the Ministry of the Health, Labour and Welfare of Japan | 2013 | Self-grading scheme used to assess the quality of the evidence |
Diagnosis and treatment of inflammatory bowel disease: First Latin American Consensus of the Pan American Crohn’s and Colitis Organisation [36] | Mexico | Pan American Crohn’s and Colitis Organization | 2016 | Oxford Center for Evidence-Based Medicine |
Mexican consensus for the diagnosis and treatment of idiopathic chronic ulcerative colitis [37] | Mexico | Mexican Association of Gastroenterology | 2017 | GRADE |
Crohn’s disease Management in adults, children and young people [38] | UK | NICE National institute for health care and excellence | 2012 | GRADE |
Second Korean guidelines for the management of ulcerative colitis [39] | Korea | Korean Association for the Study of Intestinal Diseases (KASID) | 2017 | GRADE |
AGA Clinical Practice Guidelines on the Management of Moderate to Severe Ulcerative Colitis [40] | USA | AGA American Gastroenterological Association | 2020 | GRADE |
Evidence-based clinical practice guidelines for inflammatory bowel disease [41] | Japan | The Japanese Society of Gastroenterology (JSGE) | 2018 | GRADE |
Ulcerative colitis - treatment with biologicals [42] | Brazil | Brazilian Study Group on Inflammatory Bowel Disease, Brazilian Medical Association | 2018 | GRADE |
British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults [43] | UK | British Society of Gastroenterology and others | 2019 | GRADE |
Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn’s Disease [44] | Canada | Canadian Association of Gastroenterology (CAG) | 2019 | GRADE |
Clinical Practice Guideline for the Medical Management of Perianal Fistulizing Crohn’s Disease: The Toronto Consensus [45] | Canada | Canadian Association of Gastroenterology (CAG) | 2018 | GRADE |
Crohn’s disease - treatment with biological medication [46] | Brazil | Brazilian Study Group on Inflammatory Bowel Disease, Brazilian Gastroenterology Federation, Brazilian Coloproctology Society, Brazilian Medical Association | 2018 | GRADE |
Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease [47] | Canada | Canadian Association of Gastroenterology (CAG) | 2019 | GRADE |
Evidence-based clinical practice guidelines for inflammatory bowel disease 2020 [48] | Japan | The Japanese Society of Gastroenterology (JSGE) | 2021 | GRADE |
AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn’s Disease [49] | USA | AGA American Gastroenterological Association | 2021 | GRADE |
WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting [50] | Netherlands | The World Society of Emergency Surgery WSES | 2021 | GRADE |
The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update [51] | Multinational | European Crohn’s and Colitis Organization [ECCO] and the Paediatric IBD Porto group of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN] | 2021 | Oxford Center for Evidence-Based Medicine |
Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology [52] | Poland | The Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology | 2021 | GRADE |
ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment [53] | Multinational | The European Crohn’s and Colitis Organization [ECCO] | 2020 | GRADE |
Results
Guideline characteristics
Quality assessment
Pair of reviewers | ICC | 95% CI | *P-value | aICC interpretation |
---|---|---|---|---|
RZ + PA | 0.69 | 0.02 - 0.90 | 0.020 | Moderate |
CM + JF | 0.74 | −0.07 - 0.97 | 0.065 | Moderate |
DH + RV | 0.03 | −0.03 - 0.74 | 0.292 | Poor |
DH + JF | 0.69 | −0.15 - 0.99 | 0.093 | moderate |
Global | 0.74 | 0.36 - 0.89 | 6.83e−4 | moderate |
Guideline | Scope and Purpose | Stakeholder Involvement | Rigour of Development | Clarity of Presentation | Applicability | Editorial Independence | Overall Recommendation |
---|---|---|---|---|---|---|---|
AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis [28] | 94.44 | 30.56 | 60.42 | 83.33 | 25.00 | 75.00. | Recommended, with modifications |
ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents [29] | 75.00 | 36.11 | 57.29 | 86.11 | 18.75 | 33.33 | Recommended, with modifications |
ACG Clinical Guideline: Management of Crohn’s Disease in Adults [30] | 44.44 | 5.56 | 35.42 | 72.22 | 4.17 | 29.17 | Not recommended |
European evidence based consensus on surgery for ulcerative colitis [31] | 75.00 | 36.11 | 50.00 | 66.67 | 6.25 | 29.17 | Recommended, with modifications |
Updated German Clinical Practice Guideline on “Diagnosis and treatment of Crohn’s disease” 2014 [32] | 91.67 | 86.11 | 83.33 | 61.11 | 12.50 | 91.67 | Recommended, with modifications |
Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease [33] | 72.22 | 52.78 | 61.46 | 83.33 | 12.50 | 12.50 | Recommended, with modifications |
Management of paediatric ulcerative colitis, Part 1: ambulatory care- an evidence-based guideline from ECCO and ESPGHAN [34] | 83.33 | 27.78 | 67.71 | 83.33 | 6.25 | 66.67 | Recommended, with modifications |
Evidence-based clinical practice guidelines for Crohn’s disease, integrated with formal consensus of experts in Japan [35] | 91.67 | 52.78 | 56.25 | 94.44 | 16.67 | 79.17 | Recommended, with modifications |
Diagnosis and treatment of inflammatory bowel disease: First Latin American Consensus of the Pan American Crohn’s and Colitis Organisation [36] | 75.00 | 30.56 | 60.42 | 69.44 | 12.50 | 50.00 | Recommended, with modifications |
Mexican consensus for the diagnosis and treatment of idiopathic chronic ulcerative colitis [37] | 36.11 | 19.44 | 50.00 | 63.89 | 6.25 | 62.50 | Not recommended |
Crohn’s disease Management in adults, children and young people [38] | 94.44 | 83.33 | 94.79 | 100.00 | 83.33 | 75.00 | Recommended |
Second Korean guidelines for the management of ulcerative colitis [39] | 80.55 | 58.33 | 71.88 | 100.00 | 22.92 | 29.17 | Recommended, with modifications |
AGA Clinical Practice Guidelines on the Management of Moderate to Severe Ulcerative Colitis [40] | 100.00 | 80.56 | 91.67 | 100.00 | 56.25 | 83.33 | Recommended |
Evidence-based clinical practice guidelines for inflammatory bowel disease [41] | 91.66 | 75.00 | 82.29 | 88.89 | 58.33 | 83.33 | Recommended, with modifications |
Ulcerative colitis - treatment with biologicals [42] | 88.88 | 33.33 | 45.83 | 55.56 | 6.25 | 0.00 | Not recommended |
British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults [43] | 100.00 | 100.00 | 91.67 | 100.00 | 45.83 | 100.00 | Recommended |
Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn’s Disease [44] | 100.00 | 94.44 | 85.42 | 100.00 | 25.00 | 95.83 | Recommended |
Clinical Practice Guideline for the Medical Management of Perianal Fistulizing Crohn’s Disease: The Toronto Consensus [45] | 86.11 | 91.67 | 79.17 | 100.00 | 14.58 | 95.83 | Recommended, with modifications |
Crohn’s disease - treatment with biological medication [46] | 80.55 | 44.44 | 34.38 | 44.44 | 4.17 | 0.00 | Not recommended |
Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease [47] | 100.00 | 91.67 | 90.63 | 100.00 | 37.50 | 91.67 | Recommended |
Evidence-based clinical practice guidelines for inflammatory bowel disease 2020 [48] | 77.78 | 66.67 | 66.67 | 91.67 | 18.75 | 87.50 | Recommended, with modifications |
AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn’s Disease [49] | 94.44 | 83.33 | 87.50 | 100.00 | 52.08 | 91.67 | Recommended |
WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting [50] | 86.11 | 69.44 | 63.54 | 91.67 | 25.00 | 50.00 | Recommended, with modifications |
The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update [51] | 91.67 | 66.67 | 86.46 | 100.00 | 39.58 | 100.00 | Recommended, with modifications |
Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology [52] | 94.44 | 72.22 | 71.88 | 91.67 | 33.33 | 0.00 | Recommended, with modifications |
ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment [53] | 91.67 | 94.44 | 92.71 | 97.22 | 47.92 | 100.00 | Recommended |
Mean Score | 84.51 | 60.90 | 69.95 | 85.58 | 26.60 | 62.02 | |
Median | 90.27 | 66.67 | 69.79 | 91.67 | 20.83 | 75.00 |
Domain 1: Scope and purpose
Domain 2: Stakeholder involvement
Domain 3: Rigor of development
Domain 4: Clarity of presentation
Domain 5: Applicability
Domain 6: Editorial Independence
Overall assessment
Combined assessment
Quality assessment over time
Domain | Guidelines from 2012-2017 | Guidelines from 2018-2022 | **P-value |
---|---|---|---|
Scope and purpose | 81.9 (9.15) | 85.6 (17.9) | 0.5868 |
Stakeholder involvement | 54.5 (21.0) | 63.7 (29.4) | 0.4336 |
Rigour of development | 66.9 (15.3) | 71.3 (19.6) | 0.5817 |
Clarity of presentation | 82.6 (15.3) | 86.9 (17.0) | 0.5521 |
Applicability | 23.2 (24.8) | 28.1 (19.0) | 0.5815 |
Editorial independence | 50.0 (28.7) | 67.4 (36.3) | 0.2444 |