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A Critical Appraisal of National and International Clinical Practice Guidelines Reporting Nutritional Recommendations for Age-Related Macular Degeneration: Are Recommendations Evidence-Based?

1
Division of Optometry and Visual Science, City, University of London, Northampton Square, London EC1V OHB, UK
2
International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
3
Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(4), 823; https://doi.org/10.3390/nu11040823
Received: 26 March 2019 / Revised: 5 April 2019 / Accepted: 9 April 2019 / Published: 11 April 2019
(This article belongs to the Special Issue Nutrition and Eye Health)
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Abstract

Eye care professionals should have access to high quality clinical practice guidelines that ideally are underpinned by evidence from robust systematic reviews of relevant research. The aim of this study was to identify clinical guidelines with recommendations pertaining to dietary modification and/or nutritional supplementation for age-related macular degeneration (AMD), and to evaluate the overall quality of the guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. We also mapped recommendations to existing systematic review evidence. A comprehensive search was undertaken using bibliographic databases and other electronic resources for eligible guidelines. Quality appraisal was undertaken to generate scores for each of the six AGREE II domains, and mapping of extracted nutritional recommendations was performed for systematic reviews published up to March 2017. We identified 13 national and international guidelines, developed or updated between 2004 and 2019. These varied substantially in quality. The lowest scoring AGREE II domains were for ‘Rigour of Development’, ‘Applicability’ (which measures implementation strategies to improve uptake of recommendations), and ‘Editorial Independence’. Only four guidelines used evidence from systematic reviews to support their nutritional recommendations. In conclusion, there is significant scope for improving current Clinical Practice Guidelines for AMD, and guideline developers should use evidence from existing high quality systematic reviews to inform clinical recommendations. View Full-Text
Keywords: clinical practice guidelines; systematic reviews; age-related macular degeneration; nutritional supplements; diet; nutrition; AGREE II clinical practice guidelines; systematic reviews; age-related macular degeneration; nutritional supplements; diet; nutrition; AGREE II
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Lawrenson, J.G.; Evans, J.R.; Downie, L.E. A Critical Appraisal of National and International Clinical Practice Guidelines Reporting Nutritional Recommendations for Age-Related Macular Degeneration: Are Recommendations Evidence-Based? Nutrients 2019, 11, 823.

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