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Diagnosis, Treatment & Prevention of Community Acquired Pneumonia in Pediatrics

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- Annexes

Annex Table 1.

Declaration of Conflict of Interests

The members of the guideline development/ adaptation group and the external review group have no academic, financial, or competing interests to declare and none of them were involved in the development of the original source guideline(s).

Any identified potential COI has been reported below.

Egyptian Pediatric Clinical Practice Guidelines Committee (EPG)

Guideline Adaptation Group (Clinical subgroup)

Name

Affiliation, Area of expertise / Role, Country / Primary location [work]

Declaration of interests

Interest

identified

Management plan & decision

Prof. Abla Saleh Mostafa

Professor of Pediatrics, Cairo University, Egypt

None

Not Applicable

Prof. Amal Ibrahim Hassanain

Professor of Child Health, National Research Center, Egypt

None

Not Applicable

Prof. Dina Hossam-Eldine Hamed

Ass. Prof. of Pediatrics, Cairo University, Egypt

None

Not Applicable

Prof. Dina Tawfeek Sarhan

Ass. Professor of Pediatrics, Zagazig University, Egypt

None

Not Applicable

Prof. Eman Mahmoud Fouda

Professor of Pediatrics, Ain Shams University, Egypt

None

Not Applicable

Prof. Fekry Gharib Bassiouny

Consultant of Pediatrics and Neonatology, MOHP, Egypt

None

Not Applicable

Prof. Hala Gouda Elnady

Professor of Child Health, National Research Center, Egypt

None

Not Applicable

Prof. Hala Hamdi Shaaban

Professor of Pediatrics, Cairo University, Egypt

None

Not Applicable

Prof. Hoda M. Salah El Din Metwally

Professor of Pediatrics, Faculty of medicine-Girls, Al-Azhar University, Egypt

None

Not Applicable

Prof. Magda Hassab Allah Mohamed

Professor of Pediatrics, Faculty of medicine Girls, Al-Azhar University, Egypt

None

Not Applicable

Prof. Maysaa Abdallah Saeed

Professor of Tropical medicine and infectious disease, Zagazig University, Egypt

None

Not Applicable

Prof. Mohamed Mahmoud Rashad

Professor of Pediatrics, Benha University, Egypt

None

Not Applicable

Prof. Mona Mohsen Elattar

Professor of Pediatrics, Cairo University, Egypt

None

Not Applicable

Miss. Nevin Abdalah Kamel

Head Nurse, Causality Department, Zagazig University Hospital, Egypt

None

Not Applicable

Pharmacist, Sarah Naeem Bartella Hebish

Senior clinical pharmacist, Pediatric oncology, ICU Department, National Cancer Institute, Cairo University, Egypt

None

Not Applicable

Prof. Shahenaz Mohamoud Hussien

Professor of Pediatrics, Al-Azhar University, Egypt

None

Not Applicable

Prof. Tarek Hamed

Professor of Pediatrics, Zagazig University, Egypt

None

Not Applicable

Guideline Adaptation Group (Methodology Subgroup)

Prof. Ashraf Abdel Baky

Professor of Pediatrics

Ain Shams University, Egypt

Founder and Chair of EPG

None

Not Applicable

Dr. Yasser Sami Amer

1. Pediatrics Department and Clinical Practice Guidelines and Quality Research Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia;

2. Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia;

3. Chair, Adaptation Working Group, Guidelines International Network (GIN), Perth, Scotland

4. Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.

None

Not Applicable

Dr. Nanis Sulieman

Associate Professor of Pediatrics

Ain Shams University, Egypt

None

Not Applicable

Dr. Ranin Soliman            

 

1. Assistant Professor of Evidence-based Practice, School of Life and Medical Sciences, University of Hertfordshire, Egypt.

2. Consultant at WHO/EMRO for the Clinical and Public Heath Guideline Adaptation Project in the EMR.

3. Head of Heath Economics and Value Unit, Children’s Cancer Hospital Egypt.           

None

Not applicable

Dr. Lamis Mohsen Elsholkamy

Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

Dr. Ahmad Yousef

Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

Dr. Nahla Gamaleldin

Lecturer of pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

Dr. Mona Saber

Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

External Review Group

Prof. Karima Abd-Alkhalek

Prof. of Pediatric pulmonology, Ain Shams University, Egypt

None

Not Applicable

Prof. Zeinab Radwan

Prof. of Pediatric pulmonology, Cairo University, Egypt

None

Not Applicable

Prof. Tharwt Deraz

Prof. of Pediatric pulmonology, Ain Shams University, Egypt

None

Not Applicable

Prof. Ahmed Al Sawah

Prof. of Pediatric pulmonology, Al-Azhar University, Egypt

None

Not Applicable

 

➡️Web annexes

The following annexes can be added as a package of standalone supplementary documents.

Keywords: The MeSH terms for "Guideline for the prevention and management of community-acquired pneumonia in children " on PubMed are: Adolescent, Anti-Bacterial Agents / therapeutic use, Child, Child, Preschool, Community-Acquired Infections / diagnosis, Community-Acquired Infections / drug therapy, Community-Acquired Infections / microbiology, Community-Acquired Infections / prevention & control, Humans, Infant, Infant, Newborn, Pneumococcal Vaccines, Pneumonia / diagnosis, Pneumonia / drug therapy, Pneumonia / microbiology, Pneumonia / prevention & control, Practice Guidelines as Topic, and Vaccines, Conjugate, Child, Child, Preschool, Community-Acquired Infections / drug therapy, Humans, Pneumonia / therapy, Editorial Policies, Evidence-Based Medicine, Practice Guidelines as Topic / standards, and Reproducibility of Results.

 

The health questions included: 11 questions for diagnosis, 8 for treatment, and two for prevention of CAP in children (see recommendations table).

PIPOH Model Items

•  P (patients, target population): This management pathway is intended primarily for use in previously healthy children aged 28 days -12 years presenting with community acquired pneumonia in primary health care centers, governmental hospitals private hospitals or private clinics. Exclusion: Hospital acquired pneumonia (HAP). Ventilator associated pneumonia (VAP), Patients who have underlying serious medical conditions which may affect their respiratory status (e.g. underlying lung disease, immunocompromised child, neuromuscular disorders), and Patients in need for PICU admission. Aspiration pneumonia.

•  I (interventions and practices considered/ guidelines category): Community acquired pneumonia management (Diagnosis, treatment, and prevention).

•   P (Professionals/ intended or target users and clinical specialties): Physicians: Pediatricians, Primary Health Care Physicians (PHC), Family Practitioners, nurses and clinical pharmacist.

• O (major outcomes considered): Primary outcome: Improvement of symptoms and decrease use of unnecessary medication in children with CAP. Secondary outcome: Improvement of patients’ outcome, decreased rate of hospital admission, decreased need to ICU admission with a net result of decreasing morbidity, mortality and optimizing health resources use.

•    H (Healthcare settings): Primary health care centers, Pediatricians at hospitals, and Pediatricians in private clinics in the Egyptian Healthcare system.

Annex Table 2. Inclusion and Exclusion (Eligibility Criteria)

Inclusion/Exclusion Selection Criteria for BTS Guideline 2011

 

Include

Exclude

 

Methods of development

-----

Evidence- Based CPG

-----

Consensus -Based CPG(Expert opinion)

Author(s)

 

Organization

-----

-----

Single author

Country

-----

-----

National

-----

International

Date of publication

2011

-----

Range of years( preferably not older than 5 years)

-----

-----

One year

Language(s)

-----

English

-----

-----

Arabic

-----

-----

Other

Status

-----

Original source CPG

 

-----

----

Adapted

Comments

It is developed in 2002 & scheduled to be reviewed every 3 years, but the last update was at 2011


Inclusion/Exclusion Selection Criteria for WHO Guideline 2012-2014


 

Include

Exclude

 

Methods of development

------

Evidence- Based CPG

---

------

Consensus -Based CPG(Expert opinion)

Author(s)

 

Organization

-----

-----

Single author

Country

-----

----

National

-----

International

Date of publication

2012-2014

---

Range of years( preferably not older than 5 years)

--

----

One year

Language(s)

----

English

------

----

Arabic

-----

-----

Other

Status

-----

Original source CPG

 

---

----

Adapted

Comments

Revised at health facilities2014, it contains recommendations for treatment only doesn’t include recommendations for diagnosis or prevention

 

Inclusion/Exclusion Selection Criteria for IDSA Guideline 2011

 

Include

Exclude

 

Methods of development

------

Evidence- Based CPG

------

Consensus -Based CPG(Expert opinion)

Author(s)

 

Organization

-----

-----

Single author

Country

-----

----

National

-----

International

Date of publication

2011

----

Range of years( preferably not older than 5 years)

-----

----

One year

Language(s)

----

English

------

----

Arabic

-----

-----

Other

Status

-----

Original source CPG

 

-----

----

Adapted

Comments

 


Annex Table 3. Results of the AGREE II assessment of the three source guidelines for CAP.

AGREE II/ CPGs

BTS

IDSA

WHO

Domain 1 (Scope)

90.74%

92.59%

77.78%

Domain 2 (Stakeholder)

83.33%

88.88%

76.39%

Domain 3 (Rigour)

81.25%

77.77%

76.56%

Domain 4 (Clarity)

94.44%

72.22%

81.95%

Domain 5 (Applicability)

84.72%

34.72%

70.83%

Domain 6 (Independence)

91.67%

91.66%

75%

Overall assessment 1

83.33%

83.33%

70.83%

Recommend for use

(Overall assessment 2)

Yes with modifications

Yes with modifications

Yes with modifications

 

Annex Table 4. Annex Nurses and Parents Educational Guide in Arabic

 

 





Appendix Table 5. The RIGHT-Ad@pt checklist

7 sections, 27 topics, and 34 items

Assessment

Page(s)*

Note(s)

BASIC INFORMATION

Title/subtitle

1

Identify the report as an adaptation of practice guideline(s), that is include "guideline adaptation", "adapting", "adapted guideline/recommendation(s)", or similar terminology in the title/subtitle.

Yes

No

Unclear

 

 

2

Describe the topic/focus/scope of the adapted guideline.

Yes

No

Unclear

 

 

Cover/first page

3

Report the respective dates of publication and the literature search of the adapted guideline.

Yes

No

Unclear

 

 

4

Describe the developer and country/region of the adapted guideline.

Yes

No

Unclear

 

 

Executive summary/abstract

5

Provide a summary of the recommendations contained in the adapted guideline.

Yes

No

Unclear

 

 

Abbreviations and acronyms

6

Define key terms and provide a list of abbreviations and acronyms (if applicable).

Yes

No

Unclear

 

 

Contact information of the guideline adaptation group

7

Report the contact information of the developer of the adapted guideline.

Yes

No

Unclear

 

 

SCOPE

Source guideline(s)

8

Report the name and year of publication of the source guideline(s), provide the citation(s), and whether source authors were contacted.

Yes

No

Unclear

 

 

Brief description of the health problem(s)

9

Provide the basic epidemiological information about the problem (including the associated burden), health systems relevant issues, and note any relevant differences compared to the source guideline(s).

 

Yes

No

Unclear

 

 

Aim(s) and specific objectives

10

Describe the aim(s) of the adapted guideline and specific objectives, and note any relevant differences compared to the source guideline(s).

Yes

No

Unclear

 

 

Target population(s)

11

Describe the target population(s) and subgroup(s) (if applicable) to which the recommendation(s) is addressed in the adapted guideline, and note any relevant differences compared to the source guideline(s).

Yes

No

Unclear

 

 

End-users and settings

12

Describe the intended target users of the adapted guideline, and note any relevant differences compared to the source guideline(s).

Yes

No

Unclear

 

 

13

Describe the setting(s) for which the adapted guideline is intended, and note any relevant differences compared to the source guideline(s).

Yes

No

Unclear

 

 

RIGOR OF DEVELOPMENT

Guideline adaptation group

14

List all contributors to the guideline adaptation process and describe their selection process and responsibilities.

Yes

No

Unclear

 

 

Adaptation framework/methodology

15

Report which framework or methodology was used in the guideline adaptation process.

Yes

No

Unclear

 

 

Source guideline(s)

16

Describe how the specific source guideline(s) was(were) selected.

Yes

No

Unclear

 

 

Key questions

17

State the key questions of the adapted guideline using a structured format, such as PICO (population, intervention, comparator, and outcome), or another format as appropriate.

Yes

No

Unclear

 

 

18

Describe how the key questions were developed/modified, and/or prioritized.

Yes

No

Unclear

 

 

Source recommendation(s)

19

Describe how the recommendation(s) from the source guideline(s) was(were) assessed with respect to the evidence considered for the different criteria, the judgements and considerations made by the original panel.

Yes

No

Unclear

 

 

Evidence synthesis

20

Indicate whether the adapted recommendation(s) is/are based on existing evidence from the source guideline(s), and/or additional evidence.

Yes

No

Unclear

 

 

21

If new research evidence was used, describe how it was identified and assessed.

Yes

No

Unclear

NA

 

Assessment of the certainty of the body of evidence and strength of recommendation

22

Describe the approach used to assess the certainty/quality of the body/ies of evidence and the strength of recommendations in the adapted guideline and note any differences (if applicable) compared to the source guideline(s).

Yes

No

Unclear

NA

 

Decision-making processes

23

Describe the processes used by the guideline adaptation group to make decisions, particularly the formulation of recommendations.

 

Yes

No

Unclear

 

 

RECOMMENDATIONS

Recommendations

24

Report recommendations and indicate whether they were adapted, adopted, or de novo.

Yes

No

Unclear

 

 

25

Indicate the direction and strength of the recommendations and the certainty/quality of the supporting evidence and note any differences compared to the source recommendations(s) (if applicable).

Yes

No

Unclear

 

 

26

Present separate recommendations for important subgroups if the evidence suggests important differences in factors influencing recommendations and note any differences compared to the source recommendations(s) (If applicable).

Yes

No

Unclear

 

 

Rationale/explanation for recommendations

27

Describe the criteria/factors that were considered to formulate the recommendations or note any relevant differences compared to the source guideline(s) (if applicable).

Yes

No

Unclear

 

 

EXTERNAL REVIEW AND QUALITY ASSURANCE

External review

28

Indicate whether the adapted guideline underwent an independent external review. If yes, describe the process.

Yes

No

Unclear

 

 

Organizational approval

29

Indicate whether the adapted guideline obtained organizational approval. If yes, describe the process.

Yes

No

Unclear

SNS  & NEBMC

 

FUNDING, DECLARATION, AND MANAGEMENT OF INTEREST

Funding source(s) and funder role(s)

30

Report all sources of funding for the adapted guideline and source guideline(s), and the role of the funders.

Yes

No

Unclear

 

 

Declaration and management of interests

31

Report all conflicts of interest of the adapted and the source guideline(s) panels, and how they were evaluated and managed.

Yes

No

Unclear

 

 

OTHER INFORMATION

Implementation

32

Describe the potential barriers and strategies for implementing the recommendations (if applicable).

Yes

No

Unclear

 

 

Update

33

Briefly describe the strategy for updating the adapted guideline (if applicable).

Yes

No

Unclear

 

 

Limitations and suggestions for further research

34

Describe the challenges of the adaptation process, the limitations of the evidence, and provide suggestions for future research.

Yes

No

Unclear

--

 


Guideline Registration: PREPARE-2023CN225.