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    Evaluation of clinical practice guideline quality: comparison of two appraisal tools
    (Oxford Univ Press, 2020) Koc, Esra Meltem; Aksoy, Hilal; Baser, Duygu Ayhan; Artantas, Aylin Baydar; Kahveci, Rabia; Cihan, Fatma Goksin
    Objective: The tools used for critically appraising the quality of clinical practice guidelines are complex and not suitable for the busy end users. So rapid, effective and simple instruments are more preferred. The aim of this study is to compare two critical appraisal tools: iCAHE as a rapid instrument and AGREE II as a complex instrument on guideline quality assessment. Material and Methods: The diabetes mellitus guidelines of the Scottish Intercollegiate Guidelines Network (SIGN), the National Institute for Health and Clinical Excellence (NICE), the International Diabetes Federation (IDF) and the Society of Endocrinology and Metabolism of Turkey (SEMT) were assessed separately by four appraisers using the iCAHE and AGREE II instruments. The mean iCAHE criteria scores and the total and domain AGREE II scores given by the four appraisers are presented for each guideline. Results: No statistically significant difference was detected between the iCAHE scale scores of the guidelines evaluated (P = 0.063). The rank of the guidelines according to their average total iCAHE and AGREE II instrument scores was similar. The iCAHE mean scores of the guidelines were as follows: NICE, 92.85%; SIGN, 92.85%; IDF, 66.07% and SEMT, 73.21%. The AGREE II mean scores of the guidelines were as follows: NICE, 87.13%; SIGN, 78.25%; IDF, 53.44% and SEMT, 53.22%. Conclusions: In addition to being a quality scale, the iCAHE checklist is easy, practical and short to implement. It also helps the users to understand the quality of the guideline in a shorter time. To increase the use of guidelines, it is important that users with little experience and time use the iCAHE scale as a rapid appraisal tool, but more studies are needed to decide the best appraisal tool.
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    The impact of circulating 25-hydroxyvitamin and oral cholecalciferol treatment on menstrual pain in dysmenorrheic patients
    (Taylor & Francis Ltd, 2019) Kucukceran, Hatice; Ozdemir, Ozhan; Kiral, Serkan; Berker, Dilek Sensoz; Kahveci, Rabia; Ozkara, Adem; Atalay, Cemal Resat
    This study aims to determine Vitamin-D level in patients with primary dysmenorrhea and investigate the effect of Vitamin-D replacement on symptoms. About 100 patients in the 18-30 age group followed-up with primary dysmenorrhea diagnosis were included in this observational study. The pain severity was assessed using the visual analog scale (VAS). 25-hydroxy vitamin D(25(OH)D) levels of the patients were measured and the replacement therapy was applied according to measurement results. The patients were followed for three months in total. At the end of the three-month period, the 25(OH)D level was measured and the VAS score was assessed once more after the therapy. 25(OH)D level was insufficient in 23.0%, deficient in 45.0%, and severely deficient in 32.0% of the patients. It was found that the VAS score increased as the 25(OH)D level decreased (r = -0.320; p = .002). A significant reduction was observed in VAS scores after Vitamin-D treatment in all three groups; the amount of reduction in VAS score was determined to be higher in the patients with severely deficient levels of 25(OH)D, compared to the patients with deficient or insufficient levels (p < .001). A significant and negative correlation was found between Vitamin-D and symptoms associated with dysmenorrhea in our study. The Vitamin-D replacement therapy led to a significant decrease in symptoms.
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    Quality Assessment of Clinical Practice Guidelines Developed by Professional Societies in Turkey
    (Public Library Science, 2016) Yasar, Ilknur; Kahveci, Rabia; Artantas, Aylin Baydar; Baser, Duygu Ayhan; Cihan, Fatma Goksin; Sencan, Irfan; Koc, Esra Meltem
    Background Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. There is a limited number of studies on guidelines in Turkey. The quality of Ministry of Health guidelines have formerly been assessed whereas there is no information on the other guidelines developed in the country. Aim This study aims to assess the quality of CPGs that are developed by professional societies that work for the health sector in Turkey, and compare the findings with international guidelines. Methodology Professional societies that work for the health sector were determined by using the data obtained from the Ministry of Internal Affairs. Inclusion and exclusion criteria were defined for selecting the CPGs. Guidelines containing recommendations about disease management to the doctors, accessible online, developed within the past 5 years, citing references for recommendations, about the diseases over 1% prevalence according to the Statistical Yearbook of Turkey 2012 were included in the study. The quality of CPGs were assessed with the AGREE II instrument, which is an internationally recognized tool for this purpose. Four independent reviewers, who did not participate in the development of the selected guidelines and were trained in CPG appraisal, used the AGREE instrument for assessment of the selected guidelines. Findings 47 professional societies were defined which provided access to CPGs in their websites; 3 of them were only open to members so these could not be reached. 8 CPGs from 7 societies were selected from a total of 401 CPGs from 44 societies. The mean scores of the domains of the guidelines which were assessed by the AGREE II tool were; Scope and purpose: 64%, stakeholder involvement: 37.9%, rigour of development: 35.3%, clarity and presentation: 77.9%, applicability: 49.0% and editorial independence: 46.0%. Conclusion This is the first study in Turkey regarding quality appraisal of guidelines developed by the local professional societies. It adds to the limited amount of information in the literature that comes from Turkey as well as other developing countries.
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    Quality Assessment of Clinical Practice Guidelines Developed by Professional Societies in Turkey
    (Public Library Science, 2016) Yasar, Ilknur; Kahveci, Rabia; Artantas, Aylin Baydar; Baser, Duygu Ayhan; Cihan, Fatma Goksin; Sencan, Irfan; Koc, Esra Meltem
    Background Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. There is a limited number of studies on guidelines in Turkey. The quality of Ministry of Health guidelines have formerly been assessed whereas there is no information on the other guidelines developed in the country. Aim This study aims to assess the quality of CPGs that are developed by professional societies that work for the health sector in Turkey, and compare the findings with international guidelines. Methodology Professional societies that work for the health sector were determined by using the data obtained from the Ministry of Internal Affairs. Inclusion and exclusion criteria were defined for selecting the CPGs. Guidelines containing recommendations about disease management to the doctors, accessible online, developed within the past 5 years, citing references for recommendations, about the diseases over 1% prevalence according to the Statistical Yearbook of Turkey 2012 were included in the study. The quality of CPGs were assessed with the AGREE II instrument, which is an internationally recognized tool for this purpose. Four independent reviewers, who did not participate in the development of the selected guidelines and were trained in CPG appraisal, used the AGREE instrument for assessment of the selected guidelines. Findings 47 professional societies were defined which provided access to CPGs in their websites; 3 of them were only open to members so these could not be reached. 8 CPGs from 7 societies were selected from a total of 401 CPGs from 44 societies. The mean scores of the domains of the guidelines which were assessed by the AGREE II tool were; Scope and purpose: 64%, stakeholder involvement: 37.9%, rigour of development: 35.3%, clarity and presentation: 77.9%, applicability: 49.0% and editorial independence: 46.0%. Conclusion This is the first study in Turkey regarding quality appraisal of guidelines developed by the local professional societies. It adds to the limited amount of information in the literature that comes from Turkey as well as other developing countries.