Introduction
Clinical Practice Guidelines (CPGs) are health-related documents created to provide evidence-based recommendations to healthcare professionals, policy makers, patients and other stakeholders.(1) In Mexico, CPGs are developed by the National Healthcare Technology Excellence Center (acronym in Spanish: CENETEC). CENETEC was founded in 2004 and includes the Mexican Healthcare institutions. To date, CENETEC has produced more than 760 CPGs, focusing on four categories: diseases, nursing, medical procedures and healthcare process.(2)
CPGs methodology has improved over time, from non-standardized “Good Old Boys Sitting Around a Table” (GOBSAT) approaches to standardized methods.(3) Different resources and methodologies have contributed to this improvement. Two of them particularly have been key in the guidelines methodology enterprise; The development of the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool - which is the most widely used tool to assess the quality of CPGs - and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework, which has become the reference methodological standard for the development of guidelines. (4-10)
CENETEC’s massive CPGs production may be impressive and admirable but raises the issue of the rigor with which its guidelines are produced, their applicability and usefulness. To date, few studies had appraised CENETEC guidelines with the AGREE tool,(11) however, there is no systematic assessment of the quality of the guidelines produced by the CENETEC aiming to include their entire production. The aim of the current study was to assess the quality of Mexican CPGs and to evaluate their adherence to the GRADE framework.