Clinical practice guidelines (CPGs) are statements that include recommendations intended to optimize patient care. Recommendations should be presented as clear, specific and actionable statements. The RIGHT working group is developing a checklist for reporting recommendations (RIGHT for recommendations).
We systematically analyzed recommendations from gout guidelines as an example, aiming to provide a basis for developing a reporting standard.
We systematically searched the major databases and guideline websites from their inception to January 2017 to identify and select gout CPGs. We used search terms such as 'gout', 'hyperuricemia' and 'guideline'. We included the eligible CPGs for gout according to the pre-defined inclusion and exclusion criteria after screening titles, abstracts and full texts. We extracted and analyzed the characteristics of recommendations reported in the included guidelines.
We retrieved a total of 15 gout guidelines with a range of 5 to 80 recommendations. Several indicators were used in the gout guidelines to facilitate identification of recommendations, including grouping all recommendations in a summary section, formatting recommendations in a particular or special way, using locating words for recommendations and indicating the strength of recommendation (SOR) and quality of evidence (QOE). We found some components commonly involved in recommendations for gout. The wording of recommendations varied across guidelines. Recommendations were detailed and explained in the recommendation statement section. In some guidelines, other materials accompanied the recommendations to assist their reporting.
We found variability and inconsistency in the reporting and presentation of recommendations in the current gout guidelines. The RIGHT working group is developing a reporting standard for recommendations, which is expected to change this situation.
Patient or healthcare consumer involvement:
Guideline developers can be guided to write recommendations if a standard for reporting recommendations is established. A guideline audience will better understand and apply guidelines if the recommendations are reported clearly, adequately and consistently.