African Health Sciences
Makerere University Medical School
Vol. 18, No. 3, 2018, pp. 790-798
Bioline Code: hs18097
Full paper language: English
Document type: Study
Document available free of charge
African Health Sciences, Vol. 18, No. 3, 2018, pp. 790-798
© Copyright 2018 - Govender P.
AGREE-II Appraisal of a clinical algorithm for hypotonia assessment|
Objective: The objective of this study was to systematically appraise the quality of an evidenced-based clinical algorithm for the
clinical assessment of hypotonia in children.
Design: The Appraisal of Guidelines for Research and Evaluation (AGREE) II tool with 23 items and six domains was used.
The study was located in South Africa. Ten appraisers, who were recruited based on specific selection criteria, completed the
Results: Nine appraisers recommended the EBCA without any modification. Scope and purpose (94%), stakeholder involvement (91%) and editorial independence (99%) were rated the highest with the lower scoring domains being clarity of presentation (85%) and applicability (86%) due to clarity required in areas of resource implications and auditing and monitoring criteria.
Inter-rater reliability was strong (ICC 0.7) amongst the appraisers in this study.
Conclusion: This is the first independent assessment of the methodological rigour and transparency of a clinical algorithm
using the AGREE-II instrument. Determining the quality of the EBCA for practice is essential as this would ultimately aid clinicians towards more accurate clinical assessment of hypotonia which would inevitably impact outcomes and management of
the child presenting with this symptom. Whilst the AGREE-II provided initial feedback on the methodological rigour of development, understanding that the AGREE-II instrument evaluates the guideline development process and not the content is also
essential in order to consider the next stage which would be to consider clinicians feedback on the clinical utility of this EBCA.
AGREE-II; clinical algorithm; hypotonia; low muscle tone; paediatrics.