Evidence map›Paper›PMID 33092579›Full record

SynthesisBMC health services research2020

Are clinical practice guidelines for low back pain interventions of high quality and updated? A systematic review using the AGREE II instrument.

G Castellini, V Iannicelli, M Briguglio, D Corbetta, L M Sconfienza, G Banfi, S Gianola

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07287501 (Efficacy of Pain Science Education Combined With Exercise in Older Adults With Chronic Pain), which is not on this map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07287501 narecruitingnot on this mapstarted 2025, after this paper: background citation

Efficacy of Pain Science Education Combined With Exercise in Older Adults With Chronic Pain

TypeinterventionalSponsorUniversity of SalamancaRan2025 to 2026Enrolled100ConditionsChronic PainArmsMulticomponent training combined with Pain Science Education during 8 weeks, Multicomponent training, Multicomponent training combined with Pain Science Education during 32 weeks
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

G CastelliniUnit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.ORCID http://orcid.org/0000-0002-3345-8187
V IannicelliVita-Salute San Raffaele University, Milan, Italy.
M BriguglioIRCCS Istituto Ortopedico Galeazzi, Milan, Italy.ORCID http://orcid.org/0000-0003-0801-2359
D CorbettaVita-Salute San Raffaele University, Milan, Italy.ORCID http://orcid.org/0000-0003-3981-7248
L M SconfienzaIRCCS Istituto Ortopedico Galeazzi, Milan, Italy.ORCID http://orcid.org/0000-0003-0759-8431
G BanfiVita-Salute San Raffaele University, Milan, Italy.ORCID http://orcid.org/0000-0001-9578-5338
S GianolaUnit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. silvia.gianola@grupposandonato.it.ORCID http://orcid.org/0000-0003-3770-0011

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical practice guidelines (CPGs) provide recommendations for practice, but the proliferation of CPGs issued by multiple organisations in recent years has raised concern about their quality. The aim of this study was to systematically appraise CPGs quality for low back pain (LBP) interventions and to explore inter-rater reliability (IRR) between quality appraisers. The time between systematic review search and publication of CPGs was recorded.

methodsElectronic databases (PubMed, Embase, PEDro, TRIP), guideline organisation databases, websites, and grey literature were searched from January 2016 to January 2020 to identify GPCs on rehabilitative, pharmacological or surgical intervention for LBP management. Four independent reviewers used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool to evaluate CPGs quality and record the year the CPGs were published and the year the search strategies were conducted.

resultsA total of 21 CPGs met the inclusion criteria and were appraised. Seven (33%) were broad in scope and involved surgery, rehabilitation or pharmacological intervention. The score for each AGREE II item was: Editorial Independence (median 67%, interquartile range [IQR] 31-84%), Scope and Purpose (median 64%, IQR 22-83%), Rigour of Development (median 50%, IQR 21-72%), Clarity and Presentation (median 50%, IQR 28-79%), Stakeholder Involvement (median 36%, IQR 10-74%), and Applicability (median 11%, IQR 0-46%). The IRR between the assessors was nearly perfect (interclass correlation 0.90; 95% confidence interval 0.88-0.91). The median time span was 2 years (range, 1-4), however, 38% of the CPGs did not report the coverage dates for systematic searches.

conclusionsWe found methodological limitations that affect CPGs quality. In our opinion, a universal database is needed in which guidelines can be registered and recommendations dynamically developed through a living systematic reviews approach to ensure that guidelines are based on updated evidence. LEVEL OF EVIDENCE: 1

trial registrationREGISTRATION PROSPERO DETAILS: CRD42019127619 .

Indexed as

Low Back PainDatabases, FactualHumansReproducibility of ResultsAGREE IIClinical practice guidelinesCritical appraisalGRADELow Back painQuality of evidenceSpineSystematic review

Identifiers

PMID33092579
PMCPMC7583191

What Socratic holds

Textmetadata
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.