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Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal
BACKGROUND: Clinical practice guidelines are recommendations systematically developed to assist clinical decision-making and inform healthcare. In current rheumatoid arthritis (RA) guidelines, management of the foot and ankle is under-represented and the quality of recommendation is uncertain. This...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992215/ https://www.ncbi.nlm.nih.gov/pubmed/27547242 http://dx.doi.org/10.1186/s13047-016-0167-0 |
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author | Hennessy, Kym Woodburn, James Steultjens, Martijn |
author_facet | Hennessy, Kym Woodburn, James Steultjens, Martijn |
author_sort | Hennessy, Kym |
collection | PubMed |
description | BACKGROUND: Clinical practice guidelines are recommendations systematically developed to assist clinical decision-making and inform healthcare. In current rheumatoid arthritis (RA) guidelines, management of the foot and ankle is under-represented and the quality of recommendation is uncertain. This study aimed to identify and critically appraise clinical practice guidelines for foot and ankle management in RA. METHODS: Guidelines were identified electronically and through hand searching. Search terms ‘rheumatoid arthritis’, ‘clinical practice guidelines’ and related synonyms were used. Critical appraisal and quality rating were conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. RESULTS: Twenty-four guidelines were included. Five guidelines were high quality and recommended for use. Five high quality and seven low quality guidelines were recommended for use with modifications. Seven guidelines were low quality and not recommended for use. Five early and twelve established RA guidelines were recommended for use. Only two guidelines were foot and ankle specific. Five recommendation domains were identified in both early and established RA guidelines. These were multidisciplinary team care, foot healthcare access, foot health assessment/review, orthoses/insoles/splints, and therapeutic footwear. Established RA guidelines also had an ‘other foot care treatments’ domain. CONCLUSIONS: Foot and ankle management for RA features in many clinical practice guidelines recommended for use. Unfortunately, supporting evidence in the guidelines is low quality. Agreement levels are predominantly ‘expert opinion’ or ‘good clinical practice’. More research investigating foot and ankle management for RA is needed prior to inclusion in clinical practice guidelines. |
format | Online Article Text |
id | pubmed-4992215 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49922152016-08-21 Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal Hennessy, Kym Woodburn, James Steultjens, Martijn J Foot Ankle Res Research BACKGROUND: Clinical practice guidelines are recommendations systematically developed to assist clinical decision-making and inform healthcare. In current rheumatoid arthritis (RA) guidelines, management of the foot and ankle is under-represented and the quality of recommendation is uncertain. This study aimed to identify and critically appraise clinical practice guidelines for foot and ankle management in RA. METHODS: Guidelines were identified electronically and through hand searching. Search terms ‘rheumatoid arthritis’, ‘clinical practice guidelines’ and related synonyms were used. Critical appraisal and quality rating were conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. RESULTS: Twenty-four guidelines were included. Five guidelines were high quality and recommended for use. Five high quality and seven low quality guidelines were recommended for use with modifications. Seven guidelines were low quality and not recommended for use. Five early and twelve established RA guidelines were recommended for use. Only two guidelines were foot and ankle specific. Five recommendation domains were identified in both early and established RA guidelines. These were multidisciplinary team care, foot healthcare access, foot health assessment/review, orthoses/insoles/splints, and therapeutic footwear. Established RA guidelines also had an ‘other foot care treatments’ domain. CONCLUSIONS: Foot and ankle management for RA features in many clinical practice guidelines recommended for use. Unfortunately, supporting evidence in the guidelines is low quality. Agreement levels are predominantly ‘expert opinion’ or ‘good clinical practice’. More research investigating foot and ankle management for RA is needed prior to inclusion in clinical practice guidelines. BioMed Central 2016-08-19 /pmc/articles/PMC4992215/ /pubmed/27547242 http://dx.doi.org/10.1186/s13047-016-0167-0 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Hennessy, Kym Woodburn, James Steultjens, Martijn Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal |
title | Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal |
title_full | Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal |
title_fullStr | Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal |
title_full_unstemmed | Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal |
title_short | Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal |
title_sort | clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992215/ https://www.ncbi.nlm.nih.gov/pubmed/27547242 http://dx.doi.org/10.1186/s13047-016-0167-0 |
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