Reporting completeness and methodological quality of guidelines for nutritional care of critically ill patients: A meta-research utilizing Reporting Items for practice Guidelines in HealTh Care (RIGHT) and Appraisal of Guidelines for Research & Evaluation (AGREE II)

Abstract

Studies have demonstrated that the quality and transparency of reporting Clinical Practice Guidelines (CPGs) in healthcare are low. This meta-research aimed to evaluate the adherence of nutrition CPGs for critically ill adults to the reporting RIGHT checklist and its association with the methodological quality assessed by AGREE II, along with other potential publication-related factors. A systematic search for CPGs until December 2024 was conducted. RIGHT and AGREE II were applied. Reporting completeness score was created using the data from the evaluations of whether each broken-down item of the RIGHT. Eleven CPGs were identified, none demonstrated adherence greater than 60% to the RIGHT checklist, and the mean of RIGHT score was 33.5±15.5%. There was a strong correlation between the RIGHT score and AGREE II (r=0.886). A development CPGs team including methodologist and/or statistician was associated with a higher RIGHT score (48.9±4.5 versus 27.2±11.0) and it was higher in CPGs recommended or recommended with modifications by AGREE II in comparison to those not recommended (50.1±4.6 versus 37.7±8.1 versus 17.0±6.8), and in those with acceptable and moderate compared to those with low methodological quality (50.1±4.6 versus 32.2±14.5 versus 19.3±6.2). It was also related to the language of publication, being higher in those published in English. The reporting completeness in CPGs for critically ill adults was low, with a strong correlation with the methodological quality. High values of reporting completeness scores were observed between CPGs recommended by AGREE II (with moderate or acceptable quality) and in those including a methodologist/statistician in the development team.