A quality assessment and systematic review of clinical practice guidelines on central venous catheter care in China and internationally

BACKGROUND: Although there is currently a large number of guidelines, expert consensus statements, and declarations on central venous catheters (CVCs), the methodological rigor and reporting quality of these documents remain unclear. METHODS: The study design followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Embase, and Web of Science databases, as well as guideline databases and websites specifically dedicated to infusion therapy, were comprehensively searched for articles and information on CPGs for CVC published from database inception until 2024. Excel was used for the extraction of basic information and recommendations for CVC care. Four researchers assessed the methodological and reporting quality of the CPGs via the AGREE II instrument and the RIGHT checklist. The review protocol has been registered with the International Prospective Register of Systematic Reviews (CRD42024513864). RESULTS: Thirty-seven guidelines and consensus statements regarding CVC placement were reviewed. The average scores for the AGREE II domains were 50.14% for scope and purpose, 36.84% for participants, 37.86% for rigor, 45.87% for clarity, 28.34% for application, and 47.11% for editorial independence. In terms of the RIGHT evaluation items, item 13a had the highest reporting rate at 100.00%, followed by items 1a at 97.00%, 1b at 95.00%, 4/5/6 at 92.00%, 2 at 89.00%, 7a/15/19a at 84.00%, 20 at 81.00%, 1c at 76.00%, and 9b at 73.00%, with items 12 and 17 both at 68.00% and item 16 at 65.00%. The remaining items had reporting rates less than 60%. Subgroup analysis revealed that guidelines generally scored higher than consensus statements did in all AGREE II domains (rigor, clarity, application, and independence). A comparison of the guidelines and consensus statements in terms of region indicated that the average scores for both were lower in Asia than in other regions, particularly in the areas of scope and purpose, participants, and clarity. In terms of publication year, guidelines and consensus statements published after 2017 scored higher in AGREE II clarity, as well as in the basic information and evidence dimensions of the RIGHT tool, than those published before 2017. CONCLUSIONS: The quality of the guidelines varied, although five guidelines stood out as being of particularly high quality. These guidelines hold significant potential for practical application and could be modified to align with local regulations and protocols.