Calidad de las guías de práctica clínica publicadas en nutrición de pacientes hospitalizados adultos oncológicos

Background: There is a high variability in clinical practice regarding nutritional care which could affect nutritional status of oncological patients. This variability can be diminished following evidence based recommendations from clinical practice guidelines (CPG) with good methodological quality in its development. Objective: To review and evaluate the quality of published guidelines in nutrition in hospitalized oncological adult patients. Methods: A search of CPGs was conducted in MEDLINE, EMBASE, GIN, TripDatabase and pages of recognized guidelines developers. CPGs published between 2003 and 2012 were included. Four independent reviewers assessed the quality of CPGs using the AGREE II instrument. Characteristics of assessed guidelines were extracted and analyzed. Results: 22 CPGs met selection criteria. 90% of guidelines are written in English. There was great variability in quality scores for each domain. Highest rated domain was “clarity of presentation” (median 65.95, range 19.40 to 93.10) while the lowest was “Applicability” (median 21.20, range 0 to 77.10). Sixteen guidelines scored low on “rigour of development” and six had an acceptable or good quality. Only five documents can be considered as “good quality guidelines” because they showed high performance in all domains. Conclusion: It was found a wide range of methodological quality scores of evaluated CPGs. Highest rated guidelines are made by agencies that develop guidelines but these are little known in our country. Most of the assessed guidelines have methodological weaknesses, which can affect the quality of the recommendations they make and its validity.