Systematic Review of Paediatric Neurogenic Lower Urinary Tract Dysfunction Guidelines

What is it about?

This study appraised six clinical practice guidelines (CPGs) on management of pediatric neurogenic lower urinary tract dysfunction (NLUTD) published in English from 2010 to 2022. The AGREE II instrument was used to assess the quality of the guidelines, with six reviewers independently scoring each guideline. The top three guidelines were identified as the NICE, Irish, and SBA guidelines. These guidelines scored high on most domains except applicability and editorial independence. The diagnostic and treatment recommendations of the top three guidelines were compared and presented. The study concluded that the existing CPGs provide high-quality evidence-based recommendations, but the applicability and editorial independence domains need to be considered for future updates.

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Why is it important?

This research is important because it critically appraises current international clinical practice guidelines (CPGs) on the management of paediatric neurogenic lower urinary tract dysfunction (NLUTD) and assesses their applicability to clinical practice. The study identifies gaps and limitations in the existing guidelines, which can help guide future updates to improve their utility and impact on patient outcomes. Key Takeaways: 1. Six CPGs were appraised, including NICE, European Society for Paediatric Urology, International Children's Continence Society, Irish, Spina Bifida Association (SBA), and International Brazilian Journal of Urology guidelines. 2. The NICE, Irish, and SBA guidelines were the top three CPGs identified, scoring high on most domains except applicability and editorial independence. 3. The domains that consistently had high scores were 'scope and purpose' and 'clarity of presentation,' while the domain on 'applicability' had relatively low scores in most CPGs. 4. Diagnostic and treatment recommendations of the top three guidelines were compared and presented, which can help in making evidence-based clinical decisions.