Systematic review of evidence and consensus on perianal fistula: an analysis of national and international guidelines.

Details

Serval ID
serval:BIB_A763D5C2BC7A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Systematic review of evidence and consensus on perianal fistula: an analysis of national and international guidelines.
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
Author(s)
de Groof E.J., Cabral V.N., Buskens C.J., Morton D.G., Hahnloser D., Bemelman W.A.
Working group(s)
research committee of the European Society of Coloproctology
ISSN
1463-1318 (Electronic)
ISSN-L
1462-8910
Publication state
Published
Issued date
04/2016
Peer-reviewed
Oui
Volume
18
Number
4
Pages
O119-34
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish

Abstract
Treatment of perianal fistula has evolved with the introduction of new techniques and biologicals in Crohn's disease (CD). Several guidelines are available worldwide, but many recommendations are controversial or lack high-quality evidence. The aim of this work was to provide an overview of the current available national and international guidelines for perianal fistula and to analyse areas of consensus and areas of conflicting recommendations, thereby identifying topics and questions for future research.
MEDLINE, EMBASE and PubMed were systematically searched for guidelines on perianal fistula. Inclusion was limited to papers in English less than 10 years old. The included topics were classified as having consensus (unanimous recommendations in at least two-thirds of the guidelines) or controversy (fewer than three guidelines commenting on the topic or no consensus) between guidelines. The highest level of evidence was scored as sufficient (level 3a or higher of the Oxford Centre for Evidence-based Medicine Levels of Evidence 2009, http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/) or insufficient.
Twelve guidelines were included and topics with recommendations were compared. Overall, consensus was present in 15 topics, whereas six topics were rated as controversial. Evidence levels varied from strong to lack of evidence.
Evidence on the diagnosis and treatment of perianal fistulae (cryptoglandular or related to CD) ranged from nonexistent to strong, regardless of consensus. The most relevant research questions were identified and proposed as topics for future research.

Keywords
Consensus, Evidence-Based Medicine/standards, Humans, Practice Guidelines as Topic, Rectal Fistula/therapy
Pubmed
Create date
20/02/2016 15:50
Last modification date
20/08/2019 15:12
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