Variation in recommendations for management of pediatric fever and neutropenia across databases and languages: A systematic review of clinical practice guidelines.
Asher Hancock, Brandon Fickling, Tea Reljic et al.
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In 30 seconds
This systematic review and content analysis examined evidence-based clinical practice guidelines (CPGs) for fever and neutropenia in children, assessing how database indexing and publication language affected guideline retrieval, quality, and recommendations. Fourteen guidelines met inclusion criteria: 10 in English and four in other languages. Only 5/14 (36%) were indexed in all three databases searched, and each database contained one unique guideline. Agreement between recommendations in the reviewed guidelines and an international reference guideline ranged from 33% to 100%. Methodological quality was broadly similar across language groups, with an exception for scope and purpose.
Key findings
- Only 5/14 (36%) guidelines were indexed in all three databases; each database contained one unique guideline.
- Agreement between recommendations in the 14 guidelines and the reference guideline ranged from 33% to 100%.
- Methodological quality did not differ significantly by language across AGREE-II domains except scope and purpose (95.2% versus 90.5%; p = 0.036).
Why it matters
Guideline searches may miss relevant recommendations when restricted to particular databases or languages. The wide range of agreement with an international reference also indicates that recommendations available to clinicians can differ substantially. Awareness of these retrieval and content differences is important when interpreting guidance across healthcare settings, especially where context or disease prevalence differs.
What to keep in mind
The review included 14 guidelines, and its findings concern guideline retrieval and content rather than patient outcomes or the effects of following particular recommendations.