gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Clinical practice guidelines for acute diarrhea in children: methodological quality

Meeting Abstract

  • I.D. Florez - Universidad de Antioquia, Medellin, Colombia
  • J.M. Lozano - Florida International University, Miami, FL, USA
  • J. Contreras - Universidad de Antioquia, Medellin, Colombia
  • J. Sierra - Universidad de Antioquia, Medellin, Colombia
  • C. Granados - Pontificia Universidad Javeriana, Bogota, Colombia
  • G. Briceño - Fundacion Cardio-Infantil, Bogota, Colombia
  • M.E. Tamayo - Universidad de Antioquia, Medellin, Colombia
  • J. Acosta - Universidad de Antioquia, Medellin, Colombia
  • L.H. Lugo - Universidad de Antioquia, Medellin, Colombia

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO45

doi: 10.3205/12gin077, urn:nbn:de:0183-12gin0770

Published: July 10, 2012

© 2012 Florez et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Acute diarrhea in children is associated with high morbidity globally and with high mortality in undeveloped countries. The Colombian Ministry of Health included childhood diarrhea among the conditions for which new national guidelines are being developed. Before developing a clinical practice guideline (CPG) it is advisable to assess published guidelines to consider its adaptation. The quality of published guidelines on childhood diarrhea has not been assessed.

Objective: To assess its quality of CPG on acute diarrhea or gastroenteritis in children using the AGREE-II instrument.

Methods: We searched electronic databases, national clearinghouses and non-electronic sources until august 2011. Each guideline retrieved was independently assessed using AGREE-II (Spanish version) by three clinical epidemiologists.

Results: We found 63 guidelines, 17 of which (26.9%) were evidence-based. Based on AGREE-II, domains 1 (scope and purpose) and 4 (clarity of presentation) had the highest scores, and 5 (applicability) and 6 (editorial independence), the lowest. Only six guidelines scored over 60% in the third domain (rigour of development) and were considered as “recommended”.

Discussion: There is ample room for improving the quality of GPC on diarrhea. Most of the guidelines assessed were not evidence-based, and those that were had important weaknesses in several domains, mostly in terms of report of rigour of development, applicability and editorial independence.

Implications: Developers of CPG on childhood diarrhea need to pay more attention to the methods used, as well as to the description of the applicability and the editorial independence of their recommendations.