Guidelines for the management of pelvic pain associated with endometriosis: a systematic appraisal of their quality
Abstract
Background Guidelines exist for the management of endometriosis. Validated and reliable appraisal tools exist to assess the quality of guidelines. Objectives To systematically appraise the quality of guidelines for the management of pelvic pain associated with endometriosis. Search strategy Guidelines were identified using a prospective protocol through a systematic search of MEDLINE (1951–2005), EMBASE (1974–2005), the Cochrane Library (2005, issue 2), known guideline websites and the World Wide Web. Selection criteria Type of document: guideline, consensus statement, care protocol or healthcare technology assessment produced by national or international professional organisations and societies or governmental agencies; subject: managemant of pelvic pain associated with endometriosis. Data collection and analysis Two validated appraisal tools, Cluzeau and The Appraisal of Guidelines and Research and Evaluation (AGREE), were used to quantitatively assess the quality of guidelines. Areas evaluated included ‘rigour of development’, ‘context and content’ and ‘application.’ Main results Eight of 596 potentially relevant citations identified met our inclusion criteria. The Cluzeau instrument quality score were the following: rigour of development, 53% (range 5–65%); context and content, 69% (range 29–79%) and application 20% (range 0–20%). The aplication dimension achieved significantly lower quality scores (P = 0.026 versus rigour of development and P = 0.017 versus context and content). The AGREE instrument quality scores were the following: scope and purpose, 68% (range 17–89%); stakeholder involvement, 33% (range 13–63%); rigour of development, 49% (range 10–81%); clarity of presentation, 55% (range 42–67%); applicability, 14% (range 0–28%) and editorial independence, 28% (range 8–67%). The applicability domain achieved significantly lower quality scores (P = 0.001 versus scope and purpose and P = 0.009 versus rigour of development). Author’s conclusions Guidelines for the management of pelvic pain associated with endometriosis do not comply with the recommendations for high‐quality standards.
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Non-steroidal anti-inflammatory drugs frequently fail to relieve pain, including when used alongside lesion surgery or hormone treatment.
“Furthermore, other factors are likely involved because NSAIDs are often ineffective (Allen et al., 2009), even when combined with surgical removal of lesions or hormonal therapy (Kennedy et al., 2005;Appleyard et al., 2006;Ozawa et al., 2006; Practice Committee of the American Society for Reproductive and Medicine, 2008;Vercellini et al., 2009b)”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Appleyard et al., 2006
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Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications
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- Authors
- Appleyard, T., Mann, C., & Khan, K.
- Affiliations
- Birmingham Women's Hospital (GB)
- Corresponding author
- Appleyard, T‐L
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2006-06-22
- Volume
- 113
- Issue
- 7
- Pages
- 749-757
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2063159521
- Cited by
- 34
- References
- 18
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 1
- FWCI
- 4.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- pelvic pain, guideline quality assessment, AGREE instrument, guideline applicability, pain management
- MeSH terms
- Endometriosis, Female, Humans, Quality Assurance, Health Care, Quality of Health Care, Practice Guidelines as Topic, Pelvic Pain
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