Evaluación de la calidad clínica y metodológica de las guías de práctica clínica para el manejo fisioterapéutico del paciente con enfermedad respiratoria

Abstract

Objective: To evaluate the design, structure and methodological quality of Clinical Practice Guidelines (CPG) for the management of respiratory patient through the AGREE II tool. Materials and methods: A total of 5 CPG were initially selected. The countries the CPGs come from are: The United States, England, Australia and Canada. They were published between 2003-2013. A technical document denominated as CPG, with reference to respiratory patients and physiotherapy management published in 2009 by Bott et al. «Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient,» was independently assessed by 4 authors using the Spanish version of AGREE II tool. The concordance among evaluators was calculated with Kappa (k) coefficients. Results: Both structure and methodological quality of the CPG were satisfactory, with a score of 5-7 for most of the 23 items. The fields that obtained a lower score were applicability (31%), followed by rigor of elaboration with 56%. The higher scores were found in the fields of editorial independency (88%), objectives and scopes (83%) and clarity of presentation (71%). Global concordance among evaluators was moderate ( = 0,57), this varying in accordance to the CPG evaluated between 0,33 and 0,88. Conclusions: Based on AGREE II scores, the application of the CPG published by Bott et al. is recommended for physiotherapeutic management of respiratory patients in Colombia.