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<p>PROSPERO protocol</p>
<p>Link: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017078712</p>
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<p>Citation<br />Turki Albatti, Saleh Al Salehi, Fahad Bashiri, Muddathir Hamad, Haya Al-Joudi, Hadeel Daghash,<br />Jeremy Varnham, Yasser Amer. Appraisal of clinical practice guidelines for the management of<br />attention deficit hyperactivity disorder (ADHD) using the AGREE II Instrument: a systematic review.<br />PROSPERO 2017 CRD42017078712 Available from:<br />http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017078712<br />Review question<br />The aim is to explore the quality of and critically appraise recently published evidence-based clinical practice<br />guidelines for the management of Attention Deficit Hyperactivity Disorder (ADHD)<br />Searches<br />Data Sources include:-<br />• Guidelines International Network http://www.g-i-n.net/library/international-guidelines-library<br />• National Guidelines Clearinghouse http://www.guidelines.gov<br />• EBSCO - DynaMed Plus https://dynamed.ebscohost.com/<br />• National Institute for Health and Clinical Excellence http://www.nice.org.uk/<br />• Scottish Intercollegiate Guidelines Network http://www.sign.ac.uk/index.html<br />• US National Library of Medicine, National Institutes of Health (MEDLINE/ PubMed)<br />http://www.ncbi.nlm.nih.gov/PubMed (for CPGs published as full-text articles)<br />• Google Scholar (free) http://scholar.google.com/ (for CPGs published as full-text articles) • Plus CPGs<br />published by national and international specialized scientific societies/ associations relevant to ADHD (e.g.<br />American Academy of Pediatrics, American Psychiatric Association, European Psychiatric Association, etc.).<br />Additionally, we will also conduct internet searches for CPGs published online only.<br />Types of study to be included<br />Clinical Practice Guidelines<br />Condition or domain being studied<br />ADHD in children and adolescents. The inclusion or exclusion of adults will have been at the discretion of the<br />Source CPG developers and age limits, co-morbidities, etc, should have been defined by them. We will<br />assess how this was reported as part of our appraisal using the AGREE II Instrument.<br />Participants/population<br />The participants, including inclusion and exclusion criteria, should have been specified by the guideline<br />developers and cannot be known until we begin the appraisal of the guidelines identified by our searches.<br />We will include only CPGs with a section targeting children and adolescents. Relevant items of the AGREE II<br />Instrument will be used to assess how well the scope of the CPG was reported.<br />Intervention(s), exposure(s)<br />The interventions included within the included CPGs will have been pre-defined by the CPG development<br />group to match the individual requirements within the scope. We will only consider CPGs that include the<br />comprehensive management of ADHD. The criteria of the AGREE II Instrument will be used to assess how<br />well the included interventions were reported and presented. Identified key target interventions include<br />diagnosis and assessment (i.e. parent, carer, teacher, or patient complaints, history and physical examination, psychological tools, differential diagnosis, and investigations) and treatment (i.e. psychosocial<br />interventions, pharmacological treatment, comorbidities, parents/ carers and home, monitoring, special<br />cases, transition of care from childhood to adulthood, complementary medicine, and treatment of<br />complications of pharmacological treatment)<br />Comparator(s)/control<br />Comparator(s) and control groups with inclusion and exclusion criteria may or may not have been predefined<br />by the CPG development group. Comparators would not usually be defined when multiple<br />interventions are included in the recommendations of the CPG.<br />Primary outcome(s)<br />(1) Standardize evidence-based assessment and management of ADHD including Early diagnosis and<br />intervention of ADHD and Multi-modal interventions for ADHD.<br />(2) Improve patient target outcomes and safety (e.g. symptoms of ADHD, academic performance, social<br />relationships, parent-child interactions and family stress, and risk for serious accidental injury)<br />Secondary outcome(s)<br />(1) Decrease variation of practice.<br />(2) Improve patient-related adverse health outcomes that co-occur with ADHD (e.g. substance abuse<br />disorder and smoking, sleep difficulties/disorders, physical injuries, etc.)<br />Data extraction (selection and coding)<br />Five reviewers including one CPG methodologist will independently screen the titles and abstracts of all<br />searched documents and determine the ones for full-text review and eligible CPGs for ADHD.<br />Disagreements will be resolved through discussion and consensus with the reviewers. The same five<br />reviewers will search the internet for CPGs published online only. Information relevant to rating of each of the<br />23 items on the AGREE II Instrument will be extracted from included CPGs by utilizing the online tool (MY<br />AGREE Plus) that is freely available and accessible from the AGREE Enterprise website<br />(http://www.agreetrust.org/). The authors will then independently score every item on a 1-7 scale based on<br />how well each CPG addresses the listed questions and the AGREE criteria. An additional validation of the<br />included CPGs will be conducted for inclusion of systematic reviews in the evidence-based with their<br />category whether Cochrane systematic reviews or others.<br />Risk of bias (quality) assessment<br />The AGREE II Instrument addresses the reporting of CPGs. It does not assess aspects of study design<br />quality such as appropriateness of the methods used or trustworthiness of the recommendations. We are not<br />aware of any validated instrument for assessing risk of bias of CPGs. Some of the items on the AGREE II<br />checklist are relevant to the detection of potential sources of bias (e.g. bias due to under-representation of<br />some stakeholders in the development process - items 4 and 5, reporting bias - items 9-12, bias due to<br />conflict of interest/independence of funding bodies - items 22 and 23).<br />Strategy for data synthesis<br />Descriptive statistics will be generated and presented in tabular format to summarize the characteristics of<br />the CPGs eligible for inclusion. Once all seven AGREE appraisers have scored each item on the AGREE II,<br />they will hold a meeting to discuss discrepancies between scores and address any obvious discrepancies<br />and errors. For every included CPG, we will use the 'My AGREE PLUS' (http://www.agreetrust.org/myagree/)<br />to record scores and to keep online records of individual appraiser's scores. For every single CPG, a<br />standardized quality score will be calculated for each of the six domains of the AGREE II Instrument, using<br />the equation presented in the AGREE II User’s Manual. In summary, standardized domain scores will be<br />calculated by summing up all the appraisers’ scores of the individual items in a domain and by scaling the<br />total as a percentage of the maximum possible score for that domain. This calculation is automatically<br />generated on the My AGREE PLUS platform. The overall quality of the included CPGs in each domain of the<br />AGREE II will be presented through the two overall assessments included in the instrument. Since the six<br />domains of the AGREE II are independent, standardized domain quality scores will not be aggregated.</p>
<p>Analysis of subgroups or subsets<br />The references section of included CPGs will be reviewed and assessed for inclusion of 'Systematic<br />Reviews' in the evidence-base of these CPGs (especially the Cochrane systematic reviews).<br />Contact details for further information<br />Dr. Yasser Sami Amer<br />yasser3amer@yahoo.com<br />Organisational affiliation of the review<br />The Saudi ADHD Society, Riyadh, Saudi Arabia<br />http://adhd.org.sa/en/<br />Review team members and their organisational affiliations<br />Dr Turki Albatti. Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh,<br />Saudi Arabia<br />Dr Saleh Al Salehi. Child Development Center, King Abdullah Bin Abdulaziz University Hospital, Princess<br />Noura bint Abdulrahman University, Riyadh, Saudi Arabia<br />Dr Fahad Bashiri. Division of Neurology, Department of Pediatrics, College of Medicine, King Saud<br />University Medical City, King Saud University, Riyadh, Saudi Arabia<br />Dr Muddathir Hamad. Division of Neurology, Department of Pediatrics, College of Medicine, King Saud<br />University Medical City, King Saud University, Riyadh, Saudi Arabia<br />Dr Haya Al-Joudi. Department of Neurosciences, King Faisal Specialist Hospital and Research Center,<br />Riyadh, Saudi Arabia<br />Dr Hadeel Daghash. Ada'a Program, Assistant Deputyship for Hospital Services, Ministry of Health, Riyadh<br />Mr Jeremy Varnham. Saudi ADHD Society, Riyadh, Saudi Arabia and School of Psychology, University of<br />East London, UK<br />Dr Yasser Amer. Quality Management Department and Research Chair for Evidence-Based Health Care and<br />Knowledge Translation, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia -<br />Alexandria Center for Evidence-Based Clinical Practice Guidelines, Faculty of Medicine, Healthcare Quality<br />Directorate, Alexandria University Hospitals, Alexandria University, Alexandria, Egypt<br />Anticipated or actual start date<br />04 March 2017<br />Anticipated completion date<br />30 November 2017<br />Funding sources/sponsors<br />The unified ADHD Clinical Practice Guidelines Project is the strategic project 7.2 of the Saudi ADHD Society<br />for the period 2017-2019. The Saudi ADHD Society is a registered non-profit under licence 474 from the<br />Saudi Ministry of Labor and Social Development, and the project received the Ministry approval (No. 52476)<br />on 5/8/1438.<br />The project is entirely funded by the Saudi ADHD Society.<br />No funding received from any pharmaceutical or industrial company<br />Conflicts of interest<br />None known<br />Language<br />English<br />Country<br />Saudi Arabia</p>
<p>Stage of review<br />Review_Ongoing<br />Subject index terms status<br />Subject indexing assigned by CRD<br />Subject index terms<br />Attention Deficit Disorder with Hyperactivity; Humans<br />Date of registration in PROSPERO<br />24 November 2017<br />Date of publication of this version<br />05 October 2017</p>

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