Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Clinical Practice Guidelines on Pediatric Gastroesophageal Reflux Disease: A Systematic Quality Appraisal of International Guidelines

  • Harris, Jacob (Department of Otorhinolaryngology, University of Pennsylvania) ;
  • Chorath, Kevin (Department of Otorhinolaryngology, University of Pennsylvania) ;
  • Balar, Eesha (Department of Otorhinolaryngology, University of Pennsylvania) ;
  • Xu, Katherine (Department of Otorhinolaryngology, University of Pennsylvania) ;
  • Naik, Anusha (Department of Otorhinolaryngology, University of Pennsylvania) ;
  • Moreira, Alvaro (Department of Pediatrics, University of Texas Health-San Antonio) ;
  • Rajasekaran, Karthik (Department of Otorhinolaryngology, University of Pennsylvania)
  • Received : 2021.07.03
  • Accepted : 2022.02.06
  • Published : 2022.03.15
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Abstract

Purpose: While regurgitation is a common and often benign phenomenon in infants and younger children, it can also be a presenting symptom of gastroesophageal reflux disease (GERD). If untreated, GERD can lead to dangerous or lifelong complications. Clinical practice guidelines (CPGs) have been published to inform clinical diagnosis and management of pediatric GERD, but to date there has been no comprehensive review of guideline quality or methodological rigor. Methods: A systematic literature search was performed, and a total of eight CPGs pertaining to pediatric GERD were identified. These CPGs were evaluated using the Appraisal of Guidelines for Research and Evaluation instrument. Results: Three CPGs were found to be "high" quality, with 5 of 6 domains scoring >60%, one "average" quality, with 4 of 6 domains meeting that threshold, and the remaining four "low" quality. Conclusion: Areas of strength among the CPGs included "Scope and Purpose" and "Clarity and Presentation," as they tended to be well-written and easily understood. Areas in need of improvement were "Stakeholder Involvement," "Rigor of Development," and "Applicability," suggesting these CPGs may not be appropriate for all patients or providers. This analysis found that while strong CPGs pertaining to the diagnosis and treatment of pediatric GERD exist, many published guidelines lack methodological rigor and broad applicability.

Keywords

Acknowledgement

AM reports a grant from the Parker B. Francis Foundation and a research grant from 2R25-HL126140, outside the submitted work. All other authors declare no competing interests.

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