A Critical Appraisal of the Congress of Neurological Surgeons Evidence-Based Guidelines on the Evaluation and Treatment of Patients With Thoracolumbar Spine Trauma

This study evaluates the quality of clinical guidelines for managing thoracolumbar spine trauma (TST) published by the Congress of Neurological Surgeons (CNS). It uses the AGREE II instrument to assess the guidelines' methodological quality. Five appraisers from international centers used the AGREE II tool to evaluate the quality of CNS guidelines on TST. The assessment focused on six domains: Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability, and Editorial Independence. The study found that while CNS guidelines generally have acceptable quality, some areas like Applicability and Stakeholder Involvement need improvement. However, assessors still recommended the guidelines for clinical use with or without modifications.

• 1
  The mean scores for the six AGREE II domains were: Scope and Purpose (75.2%), Stakeholder Involvement (45.4%), Rigor of Development (57.0%), Clarity of Presentation (58.7%), Applicability (16.9%), and Editorial Independence (64.1%).
• 2
  The overall quality of all CNS guidelines was rated at 52.9%. This suggests a need for improvement in several key areas to enhance the guidelines' effectiveness and usability.
• 3
  Inter-rater reliability among the appraisers was excellent, with intra-class correlation coefficients ranging from 0.903 to 0.963. This indicates a high level of agreement in the quality assessment of the guidelines.