Series: Clinical Epidemiology in South Africa. Paper 2: Quality and reporting standards of South African primary care clinical practice guidelines.
OBJECTIVE
Clinical practice guidelines (CPGs) development has evolved over the past decade, with greater emphasis now being placed on transparency, rigor of development, and reporting standards. Our evaluation assesses the quality of the guideline development processes and reporting of selected South African primary care (PC) CPGs.


METHODS
CPGs were iteratively identified by two authors, seeking CPGs reflecting common conditions with which patients present in South African PC settings. CPGs could address diagnosis, treatment, or clinical management. Each CPG was independently appraised by two reviewers using the AGREE II (Appraisal of Guideline REsearch and Evaluation) quality checklist, and the weighted scoring algorithm to calculate scores for the six domains.


RESULTS
We included 16 CPGs from the National Department of Health and clinical professional associations. Overall, the domains of rigor of development, editorial independence, and applicability had the lowest median scores (0, 4%, and 13%, respectively). Clarity of presentation reported the highest median score (69%), with seven CPGs scoring above 70%.


CONCLUSIONS
The methodological quality of the selected South African PC CPGs was generally poor to moderate. Concerted efforts should be made to ensure that transparent, rigorous, and up-to-date evidence assessments are conducted and well reported by CPG developers.
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa; European and Developing Countries Clinical Trial Partnership (EDCTP)-Africa Office, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa. Electronic address: shingai.machingaidze@mrc.ac.za.
Shingai
S
Machingaidze
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa.
Babalwa
B
Zani
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa.
Amber
A
Abrams
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa.
Solange
S
Durao
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa; Department of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505 Cape Town, South Africa.
Quinette
Q
Louw
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa.
Tamara
T
Kredo
Department of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505 Cape Town, South Africa; International Centre for Allied Health Evidence (iCAHE), City East Campus, University of South Australia, P4-18 North Terrace, Adelaide 5000, Australia.
Karen
K
Grimmer
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa; Centre for Evidence-Based Health Care (CEBHC), Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505 Cape Town, South Africa.
Taryn
T
Young
D003906:Developing Countries; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D013019:South Africa
AGREE II; Clinical practice guidelines; Primary care; Quality; Reporting standards; South Africa