<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452022000400018</article-id>
<article-id pub-id-type="doi">10.1159/000518322</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Guidelines in Gastroenterology: Careful Interpretation Is Essential]]></article-title>
<article-title xml:lang="pt"><![CDATA[Guidelines em Gastrenterologia - uma interpretação cuidadosa é fundamental]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[Catarina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[Nuno]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[Pedro Narra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Coimbra University Hospital Centre Gastroenterology Department ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Coimbra Faculty of Medicine ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>29</volume>
<numero>4</numero>
<fpage>18</fpage>
<lpage>24</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452022000400018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452022000400018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452022000400018&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Clinical practice guidelines (CPG) contain recommendations that aim to guide physicians in the diagnosis of and therapeutic approach toward patients affected by gastrointestinal (GI) pathologies. These CPG systematically combine scientific evidence and clinical judgment, culminating in recommendations that have been shown to improve patient care.  Material and Methods:  European and North American guidelines published in the area of gastroenterology in 2018 and 2019 were considered for inclusion. To standardize the results, only guidelines that used GRADE as an evidence system were included. Thus, in the end, 1,233 recommendations from 29 guidelines published between 2018 and 2019 were analyzed.  Results:  Of the 1,233 recommendations collected, 324 (26.3%) had a low level of evidence and 127 (10.3%) had a very low level of evidence, indicating little evidence or expert opinion. Of the 29 publications analyzed, 14 (48.3%) did not present any recommendation with a high level of evidence. Regarding the 1,233 individual recommendations expressed in these 29 publications, only 336 (27.25%) assumed a high level of evidence, with 277 (82.44%) referring to liver pathology. Of the recommendations evaluated, 77 were from North American societies and the remaining 1,156 were European recommendations. In relation to the first group, only 3 (3.9%) had a high level of evidence belonging to the Guidelines for Sedation and Anesthesia in GI Endoscopy.  Conclusions:  More than 25% of all recommendations currently accepted to guide patients with gastroenterological disorders are based on low-quality evidence or expert opinion. Thus, these documents should guide our performance, but clinical sense and multidisciplinarity must not be overlooked in dubious cases and with weak scientific evidence. Research should focus on the development of randomized controlled trials and systematic reviews to improve the evidence supporting the guidelines that guide clinical practice.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  As diretrizes que orientam a prática clínica contêm recomendações de forma a que os médicos possam determinar os cuidados mais adequados para cada paciente. Estas diretrizes combinam evidências científicas com o julgamento clínico, culminando em recomendações destinadas a otimizar a prestação de cuidados.  Material e Métodos:  Diretrizes publicadas na área de Gastroenterologia entre 2018 e 2019 foram consideradas para inclusão. Para padronizar os resultados, apenas diretrizes usando o GRADE como um sistema de evidência foram incluídas. Assim, foram analisadas 1,233 recomendações de 29 diretrizes publicadas entre 2018-2019.  Resultados:  Das 1,233 recomendações incluídas, 334 (26.3%) apresentavam um nível de evidência baixo e 127 (10.3%) um nível de evidência muito baixo, indicando pouca evidência ou mesmo opinião de especialistas. Das 29 publicações analisadas, 14 (48,3%) não apresentavam nenhuma recomendação com alto nível de evidência. Em relação às 1,233 recomendações incluídas nas 29 publicações, apenas 336 (27.25%) assumiam alto nível de evidência, sendo 277 (82.44%) referentes à patologia hepática. Das recomendações avaliadas, 77 eram de sociedades norte-americanas e as restantes 1,156 recomendações europeias. Em relação ao primeiro grupo, apenas 3 (3,9%) possuíam alto nível de evidência e pertenciam às &#8220;Diretrizes para sedação e anestesia em endoscopia gastrointestinal.&#8221;  Conclusões:  Mais de 25% de todas as recomendações atualmente aceites para orientar pacientes com patologias gastrointestinais são baseadas em evidências de baixa qualidade ou opinião de especialistas. Estes documentos devem orientar a nossa forma de atuar, mas o senso clínico e a abordagem multidisciplinar não devem ser esquecidos em casos duvidosos e com evidência científica fraca. A investigação deve concentrar-se no desenvolvimento de ensaios clínicos randomizados e revisões sistemáticas para melhorar as evidências que apoiam as diretrizes que orientam a prática clínica.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Guidelines]]></kwd>
<kwd lng="en"><![CDATA[Recommendations]]></kwd>
<kwd lng="en"><![CDATA[Gastroenterology]]></kwd>
<kwd lng="en"><![CDATA[Evidence level]]></kwd>
<kwd lng="pt"><![CDATA[Diretrizes]]></kwd>
<kwd lng="pt"><![CDATA[Recomendações]]></kwd>
<kwd lng="pt"><![CDATA[Gastrenterologia]]></kwd>
<kwd lng="pt"><![CDATA[Nível de evidência]]></kwd>
</kwd-group>
</article-meta>
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