Quality appraisal of clinical practice guidelines for the use of radiofrequency ablation in the treatment of thyroid nodules and cancer

Neeraj V. Suresh, Emma De Ravin, Louis Xavier Barrette, Aman Prasad, Dominic Romeo, Jinggang Ng, Alvaro Moreira, D. Gregory Farwell, Karthik Rajasekaran

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Radiofrequency ablation (RFA) has gained significant recent global interest in the treatment of benign thyroid nodules and thyroid cancer. It is a relatively new, minimally invasive, thermal ablation technique that is an alternative to surgery. Several clinical practice guidelines (CPGs), consensus statements, and recommendations currently exist for the use of RFA in the treatment of benign thyroid nodules and thyroid cancers. These documents have considerable variability amongst them, and to date, their quality and methodologic rigor have not been appraised. Objective: To identify and perform a quality appraisal of clinical practice guidelines for RFA in the treatment of benign thyroid nodules and thyroid cancer using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Methods: A comprehensive literature search was performed in MEDLINE (via PubMed), EMBASE, and SCOPUS databases from inception to November 1, 2021. Four reviewers independently evaluated each guideline using the AGREE II instrument. Scaled domain scores were generated and the threshold used for satisfactory quality was >60%. Additionally, intraclass correlation coefficients (ICCs) were calculated to determine level of agreement between reviewers. Results: Seven guidelines were selected for final evaluation based on inclusion/exclusion criteria. Two guidelines were classified “high” quality, one “average” quality, and the rest “low” quality. The “Clarity and Presentation” (65.68 ± 26.1) and “Editorial Independence” (61.32 ± 25.8) domains received the highest mean scores, while the “Applicability” (32.14 ± 22.8) and “Rigor of Development” (45.02 ± 29.8) domains received the lowest mean scores. ICC statistical analysis showed high magnitude of agreement between reviewers with a range of (0.722–0.944). Conclusion: Reflecting upon our quality appraisal, it is evident that the quality and methodologic rigor of RFA guidelines can be improved upon in the future. Our findings also elucidate the existing variability/discrepancies amongst guidelines in the indications and use of RFA.

Original languageEnglish (US)
Article number103508
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume43
Issue number4
DOIs
StatePublished - Jul 1 2022

Keywords

  • AGREE II
  • Clinical practice guideline
  • Quality appraisal
  • Radiofrequency ablation (RFA)
  • Thyroid

ASJC Scopus subject areas

  • Otorhinolaryngology

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