diagnosis and treatment of functional constipation in infants and children
- Methods
➡️Methods of search:
A comprehensive search for guidelines was undertaken to identify the most relevant guidelines to consider for adaptation. Keywords used for search are: functional constipation, Hirschsprung disease, infants, young children.
Inclusion / exclusion criteria followed in the search and retrieval of guidelines to be adapted:
• Selecting only evidence-based guidelines (guideline must include a report on methodology of development including the systematic literature searches and explicit links between individual recommendations and their supporting evidence)
• Selecting national and/or international guidelines
• Specific range of dates for publication (using Guidelines published or updated 2013 and later or the last 5 years)
• Selecting peer-reviewed publications only
• Selecting guidelines written in English language
• Excluding guidelines written by a single author
➡️The following three categories of databases and websites were searched:
1. CPG databases and libraries (e.g., GIN, ECRI, SIGN, DynaMed, BIGG-REC PAHO)
2. Bibliographic databases (e.g., PubMed, Google Scholar)
3. Specialized professional societies (related to the pediatric subspecialty)
All retrieved Guidelines were screened and appraised using AGREE II instrument (www.agreetrust.org) by at least two members. The panel decided a cut-off point or rank the guidelines (any guideline scoring above 60% on the rigor dimension was retained)
After reviewing all the previous criteria, the GDG/ GAG recommended using 1 guideline:
1- Evidence-Based Recommendations from ESPGHAN and NASPGHAN: JPGN 2014
We did Adolopment for these guidelines: (Adoption, Adaptation, and Development)
- Adoption for most of the guideline recommendations.
- Development of Good Practice Statement
➡️Contributors to the guideline development process:
Guideline Development Group (GDG)/ Guideline Adaptation Group (GAG):
The GDG/ GAG included two subgroups; the clinicians/ healthcare providers subgroup and the guideline methodologists’ subgroup.
➡️Clinicians Subgroups
The clinicians’ subgroup or clinical panel for this guideline included experts with a range of knowledge, technical skills and diverse perspectives in the field of functional constipation
The main functions of the clinical panel were adolopment of Evidence-Based Recommendations from ESPGHAN and NASPGHAN: JPGN 2014. Guidelines, determining the scope of the guideline and guideline, reviewing the evidence, and formulating evidence-informed recommendations in case of changing strength of recommendations.
➡️Guideline Methodologists Subgroup
There were 7 guideline methodologists with expertise in guidelines development, adaptation, GRADE and translation of evidence into recommendations. Methodologists provided orientation and overview of evidence-informed guideline development processes using the GRADE approach, guideline adaptation using the Adapted ADAPTE, provided AGREE II assessment of the source guidelines in collaboration with the clinician’s subgroup, generation of the EtD frameworks whenever applicable.
➡️External Review Group:
The External Review Group for this guideline comprises 3 clinical national experts who have interest and expertise in as well as eminent international reviewers.
They were identified by Egyptian Pediatric Clinical Practice Guidelines Committee (EPG) as people who can provide valuable insights during the guideline development process.
The External Review Group was asked to comment on (peer review) the final guideline to identify any criticism on the content and to comment on clarity and applicability as well as issues relating to implementation, dissemination, ethics, regulations, or monitoring, but not to change the recommendations formulated by the GDG/ GAG. The members of the External Review Group were required to submit declarations of interest before the peer review process.
➡️Guideline Development/ Adaptation Group meetings:
GDG/ GAG meetings were organized virtually (weekly/bimonthly). Due to the extensive scope of
the guideline, EPG was responsible for overseeing the adolopment process. the timetable and objectives of each meeting. GDG/ GAG meetings were also attended by members of the methodologists. Working rules for each contributor type were outlined by the chair at the start of each meeting, covering aspects such as vocal rights, voting, and evidence to decision and recommendation formulating processes.
➡️Declarations of interests:
Prospective members of the GDG/ GAG were asked to fill in and sign the standard WHO declaration of interest and confidentiality undertaking forms. All guideline members and methodologists were also asked to fill in and sign the standard WHO declaration-of-interests.
Members of the external review group will be asked to fill in and sign the standard WHO declaration-of-interests form before the peer review process.