{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:27:04Z","timestamp":1777930024390,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NeuroRehabilitation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is no comprehensive clinical practice guideline (CPG) for multiple sclerosis (MS) rehabilitation and symptom management. This study aimed to identify and appraise the quality and scope of topics covered by existing international CPGs to inform development of a future comprehensive guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic databases and grey literature were systematically searched for existing CPGs for MS. Identified guidelines were screened independently by 3 authors for inclusion criteria. Included guidelines were each appraised by 4 reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. The AGREE-II comprises 23 items organized into 6 domains assessing the quality and reporting of CPGs. Mean AGREE ratings and ranges were calculated for each quality domain. The intra class correlation coefficient (ICC) assessed inter-rater reliability. Individual recommendations were organized into broad topics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>15 CPGs published between 1998 and 2020 met the inclusion criteria. These derived from USA (n\u2009=\u20098), UK (n\u2009=\u20093), Canada (n\u2009=\u20092), and Europe (n\u2009=\u20092). Standardized scores (and range) of quality ratings for the six domains were: 1. Scope and purpose\u2009=\u200983.2% (range 53.7 \u2212100%); 2. Stakeholder involvement\u2009=\u200964.2% (range 31.9\u2013100%); 3. Rigour of development\u2009=\u200955.7% (range 12\u201393.8%); 4. Clarity of presentation\u2009=\u200979.6% (range 56.9\u2013100%); 5. Applicability\u2009=\u200934.9% (range 13.9\u201378.1%); and 6. Editorial independence\u2009=\u200960% (range 0\u2013100%). The highest scoring domains were for Scope and purpose and Clarity of presentation. Applicability was the lowest scoring domain with 12\/15 guidelines scoring low in this domain. There was moderate to excellent inter-rater reliability (0.60\u20130.96 across the 6 domains). Recommendations from the CPGs covered spasticity, fatigue, bowel, bladder, pregnancy, physical activity, cognition, mood, and\/or multi-disciplinary care topics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Existing CPGs have well-defined objectives and target populations, yet clinical applicability and rigour of development is lower. A comprehensive up-to-date MS clinical practice guideline that provides implementation support is urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538135251387611","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T10:12:33Z","timestamp":1763028753000},"page":"402-410","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality and Scope of Published International Guidelines for Multiple Sclerosis Care: AGREE II Appraisal"],"prefix":"10.1177","volume":"57","author":[{"given":"Sarah J.","family":"Donkers","sequence":"first","affiliation":[{"name":"College of Medicine, University of Saskatchewan, Saskatoon, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Berscheid","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Saskatchewan, Saskatoon, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Bayley","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine, Temerty Medicine, University of Toronto, Toronto, Canada"},{"name":"KITE research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania R.","family":"Bruno","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine, Temerty Medicine, University of Toronto, Toronto, Canada"},{"name":"KITE research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara A.","family":"Pilutti","sequence":"additional","affiliation":[{"name":"Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada"},{"name":"University of Ottawa Brain and Mind Research Institute, Ottawa, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Simpson","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine, Temerty Medicine, University of Toronto, Toronto, Canada"},{"name":"KITE research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penelope","family":"Smyth","sequence":"additional","affiliation":[{"name":"Division of Neurology, Faculty of Medicine &amp; Dentistry, University of Alberta, Edmonton, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa A.S.","family":"Walker","sequence":"additional","affiliation":[{"name":"University of Ottawa Brain and Mind Research Institute, Ottawa, Canada"},{"name":"Ottawa Hospital Research, Ottawa, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine B.","family":"Knox","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Saskatchewan, Saskatoon, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the AGREE Working Group of the Canadian MS Rehabilitation Knowledge Mobilization Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"AGREE-REX: Recommendation EXcellence [Internet]. Available from: https:\/\/www.agreetrust.org\/resource-centre\/agree-rex-recommendation-excellence\/."},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.37.2.02"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012732.pub2"},{"key":"e_1_3_2_5_1","unstructured":"American Academy of Family Physicians [Internet]. (2017). Clinical Practice Guideline Manual | AAFP."},{"key":"e_1_3_2_6_1","unstructured":"Atlas of MS. (2023). Mapping multiple sclerosis around the world Atlas of MS 3rd edition [Internet]. Available from: www.atlasofms.org."},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANS.0000000000000263"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002564"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09189-x"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090449"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-023-01895-8"},{"issue":"12","key":"e_1_3_2_12_1","first-page":"854","article-title":"Practice guideline development, grading, and assessment","volume":"40","author":"Cruz J. E.","year":"2015","unstructured":"Cruz J. E., Fahim G., Moore K. (2015). Practice guideline development, grading, and assessment. P & T : a Peer-Reviewed Journal for Formulary Management, 40(12), 854\u2013857.","journal-title":"P & T : a Peer-Reviewed Journal for Formulary Management"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08975-3"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.03.022"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/10538135251365102"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.17226\/1626"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-024-01389-1"},{"key":"e_1_3_2_18_1","article-title":"Brain health: Time matters in multiple sclerosis","volume":"9","author":"Giovannoni G.","year":"2016","unstructured":"Giovannoni G., Butzkueven H., Dhib-Jalbut S., Hobart J., Kobelt G., Pepper G., Sormani M. P., Thalheim C., Traboulsee A., Vollmer T. (2016). Brain health: Time matters in multiple sclerosis. 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