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Evaluación de la calidad de las guías de práctica clínica para el trastorno neurocognitivo mayor por Alzheimer
Assessing the quality of clinical practice guidelines for major neurocognitive disorder due to Alzheimer's
DOI:
https://doi.org/10.15446/rsap.v26n5.114031Palabras clave:
Enfermedad de Alzheimer, demencia, guía de práctica clínica, consenso, práctica clínica basada en la evidencia (es)Alzheimer disease, dementia, practice guideline, consensus, evidence-based practice (en)
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Objetivo Evaluar las guías de práctica clínica para el abordaje de la enfermedad de Alzheimer, aplicando el instrumento AGREE-II, y establecer la calidad de las recomendaciones para su diagnóstico, tratamiento y rehabilitación.
Métodos Se hizo una búsqueda sistemática de literatura para identificar las guías de práctica clínica que presentaran recomendaciones sobre el diagnóstico y el tratamiento de pacientes con trastorno neurocognitivo mayor debido a enfermedad de Alzheimer, publicadas en los últimos diez años. Se construyó una estrategia de búsqueda compuesta por vocabulario controlado y lenguaje libre. La extracción de los datos fue llevada a cabo por un investigador. Posteriormente, dos investigadores, de manera independiente, hicieron la evaluación de la calidad de las guías seleccionadas. La síntesis cualitativa de los estudios se resumió en tablas.
Resultados La búsqueda en las bases de datos arrojó 6 281 resultados, de los cuales se seleccionaron tres artículos para la síntesis cualitativa, publicados en Australia (2016), Colombia (2017) y Reino Unido (2018). La calidad, medida con la herramienta AGREE II, fue 59,5% en promedio. Todos los dominios se cumplieron adecuadamente en dos de las guías seleccionadas. El dominio más afectado fue el de aplicabilidad y el de mayor puntaje fue el de alcance y objetivo.
Conclusiones Si bien el adecuado cumplimiento de los dominios evaluados permite hacer recomendaciones para el abordaje multidisciplinario de las personas con enfermedad de Alzheimer, debido al bajo nivel de evidencia global se requiere continuar la investigación en esta patología de forma que se garantice la homogeneidad en la atención en salud.
Objective To assess the clinical practice guidelines for the approach to Alzheimer's disease, by applying the AGREE-II instrument, and establish the quality of the recommendations for its diagnosis, treatment, and rehabilitation.
Methods A systematic literature search was made to identify clinical practice guidelines that show recommendations on the diagnosis and treatment of patients with major neurocognitive disorders due to Alzheimer's disease, published in the last ten years. A search strategy composed of controlled vocabulary and free language was constructed. One researcher carried out data extraction. Subsequently, the quality evaluation of the selected guides was carried out by two researchers independently. The qualitative synthesis of the studies was summarized in tables.
Results Research in the databases yielded 6,281 results, of which 3 articles were selected for qualitative synthesis, published in Australia (2016), Colombia (2017), and the United Kingdom (2018). The quality, measured using the AGREE II tool, was 59.5% on average. All domains were adequately met in two of the selected guides. The most affected domain was applicability and the one with the highest score was scope and objective.
Conclusions Although the adequate compliance of the evaluated domains allows us to establish recommendations for the multidisciplinary approach of people with Alzheimer's disease, due to the low level of global evidence, it is necessary to continue research in this pathology in a way that guarantees homogeneity in care in health.
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