A critical review of recent clinical practice guidelines for pediatric urinary tract infection

  • Michael Chua The Hospital for Sick Children
  • Jessica Ming The Hospital for Sick Children
  • Shang-Jen Chang Tzu Chi Buddhist General Hospital, Taipei, Taiwan
  • Joana Dos Santos The Hospital for Sick Children
  • Niraj Mistry The Hospital for Sick Children
  • Jan Michael Silangcruz St. Luke's Medical Center- Philippines
  • Mark Bayley Toronto Rehabilitation Institute- University Health Network
  • Martin A. Koyle The Hospital for Sick Children

Abstract

Introduction: Concerns regarding the quality, credibility, and applicability of recently published pediatric urinary tract infection (UTI) clinical practice guidelines have been raised due to the inconsistencies of recommendations between them. We aimed to determine the quality of the recent clinical practice guidelines on pediatric UTI by using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument, and summarize the standard of care in diagnosis and management of pediatric UTI from the top three clinical practice guidelines.

Methods: A systematic literature search was performed on medical literature electronic databases and international guideline repository websites. English language-based clinical practice guidelines from 2007–2016 endorsed by any international society or government organization providing recommendations for the management of pediatric UTI were considered. Eligible clinical practice guidelines were independently appraised by six reviewers using the AGREE II tool. Clinical practice guidelines were assessed for standardized domains and summarized for overall quality. Interrater reliability was assessed using inter-class coefficient (ICC).

Results: Thirteen clinical practice guidelines were critically reviewed. The Spanish clinical practice guidelines, American Academy of Pediatrics, and National Institute for Health and Clinical Excellence clinical practice guidelines consistently scored high on all AGREE domains (total averaged domain scores 90, 88, and 88, respectively). Among the six reviewers, there was a high degree of inter-rater reliability (average measure ICC 0.938; p<0.0001). There is reasonable consensus among the top three clinical practice guidelines in their major recommendations.

Conclusions: The clinical practice guidelines from Spain, American Academy of Pediatrics, and National Institute for Health and Clinical Excellence, with their major recommendations being similar, have scored highly on the AGREE II indicators of quality for the clinical practice guidelines development process.

Author Biographies

Michael Chua, The Hospital for Sick Children
Division of Urology Clinical Fellow
Jessica Ming, The Hospital for Sick Children
Division of Urology- Clinical Fellow
Shang-Jen Chang, Tzu Chi Buddhist General Hospital, Taipei, Taiwan
Division of Urology- Head
Joana Dos Santos, The Hospital for Sick Children
Division of Urology- Medical Staff
Niraj Mistry, The Hospital for Sick Children
Department of Pediatrics- Staff
Jan Michael Silangcruz, St. Luke's Medical Center- Philippines
Institute of Urology- Resident
Mark Bayley, Toronto Rehabilitation Institute- University Health Network
Toronto Rehabilitation Institute- staff
Martin A. Koyle, The Hospital for Sick Children
Division of Urology- Chief
Published
2017-12-16
How to Cite
Chua, M., Ming, J., Chang, S.-J., Dos Santos, J., Mistry, N., Silangcruz, J. M., Bayley, M., & Koyle, M. (2017). A critical review of recent clinical practice guidelines for pediatric urinary tract infection. Canadian Urological Association Journal, 12(4), 112-8. https://doi.org/10.5489/cuaj.4796
Section
Original Research