| 000 | 02710cam a2200193 4500500 | ||
|---|---|---|---|
| 005 | 20260329022526.0 | ||
| 041 | _afre | ||
| 042 | _adc | ||
| 100 | 1 | 0 |
_aKasbi, Merwan _eauthor |
| 700 | 1 | 0 |
_aSaouli, Reda _eauthor |
| 700 | 1 | 0 |
_aDibao-Dina, Clarisse _eauthor |
| 700 | 1 | 0 |
_aBoussageon, Rémy _eauthor |
| 245 | 0 | 0 | _aAre clinical practice guidelines on glycemic control in diabetes based on meta-analyses? |
| 260 | _c2025. | ||
| 500 | _a41 | ||
| 520 | _aBackground. Clinical practice guidelines (CPGs) are commonly used tools in the management of chronic conditions such as type 2 diabetes (T2D). In line with the principles of evidence-based medicine (EBM), CPGs should be based on systematic reviews and meta-analyses of randomized controlled trials (RCTs). This study evaluates the extent to which CPGs on glycemic control in type 2 diabetes draw on existing meta-analyses of randomized controlled trials to justify their recommendations, and whether they use the GRADE approach for quality assessment. Methods. Building on a previous study assessing the quality of CPGs (Tudrej et al. 2020), an additional study was conducted, including guidelines published between January 2015 and May 2021. Meta-analyses were selected from a systematic review by Rodriguez et al., which focused on the benefits and risks of intensive glycemic control. CPGs were categorized as “EBM-compliant” if they cited or included meta-analyses covering clinically relevant, patient-centered outcomes: total mortality, macrovascular and microvascular complications, and symptomatic hypoglycemia. Use of the GRADE approach was also examined. Results. Of the 28 CPGs analyzed, only 14% (4/28) were “EBM-compliant,” citing relevant meta-analyses to support their recommendations. Two-thirds (67%) of CPGs did not cite any of the 10 key meta-analyses. GRADE was used by 21% (6/28) of CPGs, of which only 2 were also “EBM-compliant.” Discussion. The majority of CPGs did not incorporate high-level evidence from meta-analyses of RCTs, raising concerns about the rigor and transparency of these guidelines. The lack of systematic integration of evidence could affect the quality of clinical decisions, suggesting a need for improved methodology in the development of CPGs related to glycemic control in type 2 diabetes. Conclusion. This study reveals significant gaps in the evidence base for CPGs on type 2 diabetes, highlighting the need for better adherence to EBM principles and the systematic use of robust meta-analyses in guideline development. | ||
| 786 | 0 | _nMédecine | 21 | 1 | 2025-03-03 | p. 22-28 | 1777-2044 | |
| 856 | 4 | 1 | _uhttps://stm.cairn.info/revue-medecine-2025-1-page-22?lang=en&redirect-ssocas=7080 |
| 999 |
_c1920691 _d1920691 |
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