Evaluation of the methodological quality of the Health Protection Agency’s 2009 guidance on neuraminidase inhibitors

Hopayian, Kevork MD FRCGP
Jackson, Lucy MB ChB

Honorary Senior Lecturer, Norwich Medical School, Norwich and GP, Leiston Surgery, Leiston, UK
Honorary Senior Lecturer, Norwich Medical School, Norwich and GP, Leiston Surgery, Leiston, UK

FUNDING

None.

ETHICAL APPROVAL

This was a study of published texts so ethical approval was not required.

PEER REVIEW

Not commissioned; externally peer reviewed.

CONFLICTS OF INTEREST

The clinical workload of KH and LJ is affected by the HPA guidelines.

ADDRESS FOR CORRESPONDENCE

Kevork Hopayian, Leiston Surgery, Main St, Leiston IP16 4ES, UK. Email: [email protected]

Received 28 September 2011

Accepted 14 January 2012

Quality in Primary Care 20(1):p 69-75, 2012.

Background

The Health Protection Agency (HPA) issued guidance advocating the prescription of neuraminidase inhibitors in July 2009 in response to a predicted pandemic of influenza. Although the contents of the guidance have been debated, the methodology has not.

Method

The guidance was evaluated by two reviewers using a validated and internationally recognised tool for assessing guidelines, the Appraisal of Guidelines Research & Evaluation instrument (AGREE). This tool scores six domains independently of each other.

Results

The guidance scored 61% for the domain scope and purpose and 54% for the domain clarity and presentation. By contrast, it scored only 31% for rigour of development due to poor linkage of its recommendations to evidence.

Conclusion

The HPA should improve its performance in this domain to general practitioners in order to improve the credibility of its future guidance.