Avaliação do processo de desenvolvimento de diretrizes para a prática clínica em odontopediatria: perspectiva da equipe

Abstract

Clinical practice guidelines (CPD) are systematically developed documents, based on the evaluation of the best available evidence, with the purpose of assisting professionals and managers in decision-making in clinical practice for individuals, populations and health systems. The objective of this work was to evaluate the perception of the different participants involved, coordinators and panelists, in relation to the CPD development, adaptation or adoption process. Exploratory research was carried out, with a convenience sample in two cross-sectional studies, through online self-administered questionnaires. The data obtained were tabulated in the Microsoft Excel program and a descriptive analysis was performed. All coordinators linked to the GODeC initiative, participants in the development or adaptation of guidelines for clinical practice, and all panelists of the team of specialists of the guidelines in Pediatric Dentistry, who made the recommendations of at least 50% of the formulated questions of the guideline were included. Guidelines that included questions in the area of Pediatric Dentistry, with recommendations for permanent and primary dentition, were included. Of the 22 dental guidelines under development and/or adaptation, 6 are related to Pediatric Dentistry. Forty-one panelists from these 6 guidelines received the questionnaire, and only 14 responded. Fourteen coordinators received the questionnaire, of which 12 responded. Most coordinators used the GRADE tool (Grading of Recommendations Assessment, Development and Evaluation) to assist in the development of guidelines. The vast majority of coordinators who used the EtD structure did not find it difficult to interpret the criteria. However, some difficulties were encountered by both coordinators and panelists, such as equity, cost-effectiveness, use of resources. In addition, some factors were considered of greater difficulty in the development of guidelines, such as the great demand for criteria and judgments that must be fulfilled; systematic reviews without meta-analysis; assessing the certainty of evidence and encompassing all perspectives from diverse stakeholders. In addition, participants believe that the generated recommendations are capable of being implemented by primary health care dentists. In conclusion, through the results found, it was possible to understand the dynamics adopted in the development of guidelines, in addition to the perception and difficulties encountered by coordinators and panelists during this process. This study could help to identify the main limitations in the elaboration of CPD, contributing to the improvement of its development.