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Peprah K, Frey N. Intranasal and Intramuscular Naloxone for Opioid Overdose in the Pre-Hospital Setting: A Review of Comparative Clinical and Cost-Effectiveness, and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Mar 16.

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Intranasal and Intramuscular Naloxone for Opioid Overdose in the Pre-Hospital Setting: A Review of Comparative Clinical and Cost-Effectiveness, and Guidelines [Internet].

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Appendix 4Critical Appraisal of Included Publications

Table 4. Strengths and Limitations of Randomized Controlled Trials using Downs and Black Checklist.

Table 4

Strengths and Limitations of Randomized Controlled Trials using Downs and Black Checklist.

Table 5Strengths and Limitations of Guidelines38

StrengthsLimitations
Lavonas, 201519 – American Heart Association Guidelines Update
  • The objectives, targeted users and population to whom it was meant to apply were well-described. Topics for systematic review were prioritized based on clinical significance and availability of new evidence
  • Members of ILCOR and the AHA ECC staff collaborated with consultants to develop the SEERS website to facilitate the structured and consistent evidence review process for the guidelines.
  • All draft recommendations, as well as the ILCOR draft consensus on science statements and treatment recommendations and the CoSTR drafts were posted to allow public comment, including conflict of interest disclosures.
  • The recommendations were reached by consensus, where possible, using the AHA COR and LOE process. The quality of evidence was evaluated using the GRADE process for evidence evaluation, which is a validated and widely used tool.
  • In place of cyclical procedure for updating the guidelines, a continuous evidence evaluation and guidelines update process has been instituted using online publication.
  • The recommendations are specific and clear, with options for managing a variety of conditions.
  • Criteria for evidence selection and procedure for updating the guideline were not available for assessment. However, with 250 reviewers from 39 countries addressing 439 PICO questions by systematic reviews and evidence evaluation, using well validated tools, it is unlikely that this is a source of quality concern

AHA = American Heart Association; COR = Classes of Recommendation; CoSTR = Consensus on Science with Treatment Recommendations; GRADE = Grading of Recommendations Assessment, Development, and Evaluation; ILCOR = International Liaison Committee on Resuscitation; LOE = Levels of Evidence; PICO = population, intervention, comparator, outcome; SEERS = Systematic Evidence Evaluation and Review System

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Bookshelf ID: NBK470684
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