Key result
A systematic review identified 18 clinical practice recommendations for neurocognitive management in congenital heart disease, focusing on surveillance, screening, evaluation, and counseling, with an average AGREE-II score of 89.6.
Why the study?
Recommendations on neurocognitive management of patients with congenital heart disease presented in clinical practice guidelines and scientific statements needed synthesis and critical assessment.
Systematic Review (n=6)
Existing recommendations for neurocognitive management in CHD focus on surveillance and screening, and could be adapted for local contexts despite implementation barriers.
High-quality neurocognitive CHD recommendations support surveillance; adaptation to local settings feasible despite barriers.
The aim of the study was to synthesize and critically assess the recommendations on neurocognitive management of patients with congenital heart disease (CHD) presented in clinical practice guidelines and scientific statements. Methods: A systematic review of practice recommendations (PROSPERO CRD42020205202). PubMed, SCOPUS, Ovid/ Cochrane, and LILACS was searched, and repositories of scientific societies and references of included documents were reviewed. Critical appraisal was performed using the Appraisal of Guidelines for Research and Evaluation (AGREE)-II (ideal scenario) for the guidelines and statements, and recommendations were assessed using the AGREE-REX (ideal and local scenarios). A matrix of recommendations and analysis of potential barriers for their implementation in Colombia is presented. Results: Eighteen related recommendations were included in the study. The average AGREE-II was 89.6. The average AGREE-REX was 90.1 in the ideal setting and 69.9 in the local setting. The included recommendations focus on surveillance, screening, evaluation, and counseling; no recommendations on neurocognitive interventions were identified. The main implementation barriers in Colombia are the healthcare system's unwillingness to pay, and the lack of a comprehensive care package for neurocognitive management in CHD. Conclusion: The identified recommendations could be adapted into a Colombian practice guideline, with modifications for the local context.
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Rojas‐Gualdrón et al. (2023) conducted a systematic review in Congenital heart disease (n=6). Neurocognitive management recommendations was evaluated on Methodological quality and implementability of recommendations (AGREE-II and AGREE-REX scores). A systematic review identified 18 clinical practice recommendations for neurocognitive management in congenital heart disease, focusing on surveillance, screening, evaluation, and counseling, with an average AGREE-II score of 89.6.
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