• Pol. Arch. Med. Wewn. · Nov 2023

    Review

    Consistency assessment and visualization on recommendations for gastroesophageal reflux disease: a scoping review of clinical practice guidelines.

    • Xin-Yu Zhang, Ke-Lu Yang, Shi-Qi Wang, Yang Li, Rui-Shu Li, Ke-Wei Jiang, Xiao-Nan Liu, and Quan Wang.
    • Ambulatory Surgery Center, Xijing Hospital, Air Force Military Medical University, Xi’an, China
    • Pol. Arch. Med. Wewn. 2023 Nov 29; 133 (11).

    IntroductionGastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder that causes diverse esophageal and extraesophageal symptoms. Many clinical practice guidelines (CPGs) have been issued around the world to provide practical evidence regarding GERD management. However, some of the recommendations discussed in various CPGs are inconsistent across individual documents.ObjectivesWe aimed to summarize the evidence from CPGs on GERD and assess the consistency of the recommendations.Patients And MethodsIn this scoping review, we identified current CPGs on the clinical management of GERD, which were comprehensively searched for in electronic databases and on relevant scientific websites. The recommendations were extracted using the population‑intervention‑comparison framework and were subsequently categorized into tables.ResultsUltimately, 24 CPGs were identified. They included 86 recommendations, which were classified into 5 categories: definition, epidemiology, diagnosis, treatment, and complications. Among the identified recommendations, 68 were proposed in at least 2 CPGs, and they were assessed for the consistency of direction and strength. Overall, 32.4% of the recommendations (22/68) were consistent in direction and strength, whereas 60.3% (41/68) were consistent in direction but inconsistent in strength. Moreover, 7.4% (5/68) were inconsistent in direction. These referred to the relationship between GERD and tobacco consumption, Helicobacter pylori infection, diagnostic utility of the 2‑week proton pump inhibitor test, cessation of special food, and antireflux surgery for GERD with extraesophageal symptoms.ConclusionsMost CPG recommendations regarding GERD were consistent in direction, except for 5 discrepancies, for which further well‑designed, large‑scale research is required to explain the inconsistency.

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