Avaliação crítica de diretrizes clínicas do tratamento da doença obstrutiva carotídea

Abstract

Background: The therapies of choice for the treatment of obstructive carotid artery disease (CAD) are currently widely discussed topics. One of the main reasons was the technological evolution and advances in surgical techniques. Vascular surgery underwent major changes, which expanded the options for clinical and surgical therapeutic approaches. General objective: To assess the quality of existing clinical guidelines and consensus on the treatment of carotid obstructive arterial disease (CAD). Specific objectives: Assess the methodological rigor and degree of transparency of existing clinical guidelines and consensus on the treatment of CAD. Methods: This is a retrospective observational study, with a systematic analysis of clinical guidelines and consensuses published between 2000-2019, which address the treatment of COAD, using the AGREE II assessment instrument (Appraisal of Guidelines Research and Evaluation II), which consists of a checklist with 23 items, developed to standardize the evaluation and elaboration of DCs. Results: 09 DCs were selected for application of the AGREE II methodological analysis of DCs that address the diagnosis and treatment of CAD by 3 independent evaluators. Most of the selected DCs were published in 2011 or later (66%). Domain 3 of the instrument was predefined as the primary outcome, which assesses the methodological rigor and degree of transparency in the development of the guideline. Low methodological quality was observed in DCs 3 and 9, and moderate methodological quality in DCs 5 and 8. The DCs with high methodological quality were 1, 2, 4, 6 and 7, all scoring above 80% in domain 3. Conclusion: Based on the results of this study, it can be concluded that most of the DCs on the treatment of CAD evaluated have high global methodological quality with a high degree of interrater agreement, considering scores above 80% in domain 3 (rigor of development) for 5 of the 9 DCs analyzed.