Clinical practice guidelines in idiopathic facial paralysis: systematic review using the appraisal of guidelines for research and evaluation (AGREE II) instrument

Neil N. Luu, Kevin T. Chorath, Brandon R. May, Nuvid Bhuiyan, Alvaro G. Moreira, Karthik Rajasekaran

Research output: Contribution to journalArticlepeer-review

Abstract

Bell’s palsy, or idiopathic facial paralysis, is a peripheral facial palsy of unknown cause that presents as sudden, unilateral weakness of the muscles of the face. Prompt treatment of Bell’s palsy is critical in order for patients to achieve complete recovery of facial function. Delays in diagnosis and management can result in permanent facial defects. A number of clinical practice guidelines (CPG) exist to guide clinical decision-making in patients presenting with idiopathic facial paralysis. However, to date, there has been no comprehensive review of the methodological rigor and quality of these CPGs. Thus, the objective of the authors is to appraise the existing CPGs to ensure safe and effective practices. A total of eight guidelines met the inclusion criteria and were appraised. Only two CPGs achieved an overall rating of ‘High’, having five or more quality domains scoring > 60%. Across the CPGs, the domains of rigor of development, stakeholder involvement, and applicability has the lowest overall scores with 48.1%, 43.9%, and 43.1%, respectively. Based on the AGREE II instrument, the methodological rigor and quality of CPGs for Bell’s palsy is low to average. In particular, future guidelines for Bell’s palsy should look to the quality domains of rigor of development, stakeholder involvement, and applicability as the greatest opportunities for improvement.

Original languageEnglish (US)
JournalJournal of Neurology
DOIs
StateAccepted/In press - 2021

Keywords

  • AGREE II
  • Bell’s palsy
  • Clinical practice guidelines
  • Idiopathic facial paralysis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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