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European psychiatric treatment guidelines: is the glass half full or half empty?

Published online by Cambridge University Press:  16 April 2020

M. Stiegler ,
C. Rummel ,
K. Wahlbeck ,
W. Kissling  and
S. Leucht
M. Stiegler*
Affiliation:
Department of Psychiatry and Psychotherapy, Technische Universität München, Ismaningerstr. 22, 81675Munich, Germany
C. Rummel
Affiliation:
Department of Psychiatry and Psychotherapy, Technische Universität München, Ismaningerstr. 22, 81675Munich, Germany
K. Wahlbeck
Affiliation:
National Research and Development Center for Welfare and Health (STAKES), Mental Health Unit, P.O. Box 220, 00531 Helsinki, Finland
W. Kissling
Affiliation:
Department of Psychiatry and Psychotherapy, Technische Universität München, Ismaningerstr. 22, 81675Munich, Germany
S. Leucht
Affiliation:
Department of Psychiatry and Psychotherapy, Technische Universität München, Ismaningerstr. 22, 81675Munich, Germany
*
*Corresponding author. Tel.: +49 89 4140 6743; fax: +49 89 4140 6738. E-mail address:m.stiegler@lrz.tum.de. (M. Stiegler).
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Abstract

Purpose

We assessed the quality of European treatment guidelines in the field of mental health that have been produced by national psychiatric associations. The main focus was the question of whether the development process of the guidelines followed basic principles of evidence-based medicine.

Methods

Sixty-one European clinical practice guidelines from 14 countries, published between 1998 and 2003, were assessed using the ‘Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument’. The domain score was calculated for each of the six domains of the AGREE instrument. The seven items of the domain “rigor of development” and one additional item concerning national particularities were assessed in detail.

Results

The mean scores in the six domains were rather low, although the quality varied among the different guidelines. The highest mean score was obtained in the domain clarity and presentation (70.8% S.D. 23.5), the lowest on editorial independence (19.7% S.D. 29.3). The recommendations of about half of the assessed guidelines could be considered to be evidence-based.

Conclusion

The assessed guidelines showed a broad range of quality: some producers attached importance to an evidence-based development process; but in spite of this, a large number of guidelines were only of middling quality. As national particularities are only rarely mentioned and the development process of guidelines is complex, an international collaboration that aims toward the production of shareable guidelines might be promising.

Keywords

Psychiatric guidelinesQuality of guidelinesEuropeTreatment
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 8 , December 2005 , pp. 554 - 558
Copyright
Copyright © Elsevier SAS 2005

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