Appraisal of WHO Guidelines in Maternal Health Using the AGREE II Assessment Tool

Abstract

In 2007, the World Health Organization (WHO) received a criticism for a lack of transparency and systematic methods in the development of guidelines, which were at that time perceived as substantially driven by expert opinion. In this paper we assessed the quality of maternal and perinatal health guidelines developed since then. We used the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool to evaluate the quality of methodological rigour and transparency of four different WHO guidelines published between 2007 and 2011. Our findings showed high scores among the most recent guidelines on maternal and perinatal health suggesting higher quality. However, there is still potential for improvement, especially in including different stakeholder views, transparency of guidelines regarding the role of the funding body and presentation of the guideline document.

Pediatric Clinical Practice Guidelines for Acute Procedural Pain: A Systematic Review

“…This finding is not dissimilar to those of many other systematic reviews of guidelines targeting other health conditions (eg, endocrine disorders, 40 acute gastroenteritis, 42 and cardiovascular disease 49 ). Unlike another review, 50 in which authors showed an increase in domain scores in more recent guidelines, we did not find the same trend in our review. Possible reasons could be a lack of awareness of the AGREE II criteria or inadequate or lack of reporting them.…”

“…Similar to Polus and colleagues 50 in their appraisal of World Health Organization guidelines using the AGREE II Instrument, reviewers found that providing an overall assessment score was challenging. This difficulty could be related to the lack of scoring detail provided in the AGREE II training resource, which did not specify how scores corresponded with decisions for recommending the guideline for use in practice.…”

“…The use of the AGREE II Instrument with established reliability and validity 19,20 added credibility to the ratings and conclusions. This measure has broad applicability to a variety of health care professionals and settings because of its generic nature, 15,50 and it provides a framework to evaluate the guidelines by focusing on a comprehensive set of domains. This comprehensiveness allows reviewers to systematically evaluate each guideline in a specific, detailed, and objective fashion.…”

“…Furthermore, readers should be cautioned that AGREE II scores should be interpreted in the context of the clinical setting. 50 The term stakeholder could be defined more broadly in the AGREE II criteria to ensure that the criteria are more applicable in pediatric contexts (eg, inclusion of parents and health care provider views). Finally, the current study is potentially susceptible to bias because the assessors were not blinded to authors or year of guideline publication.…”

A critical review of recent clinical practice guidelines on the diagnosis and treatment of non-neurogenic male lower urinary tract symptoms

“…3,4 With such concerns, the AGREE Collaboration (Appraisal of Guidelines, Research and Evaluation) created a 23-item tool (AGREE II tool) targeting 6 quality-related domains to assess the quality of CPGs; this AGREE II tool has become an internationally well-accepted standard to evaluate guidelines. 5,6 Faced with conflicting and inconsistent guidelines, urologists rightly maintain a healthy skepticism and are able to identify reliable guidelines. To determine the qualities, similarities and differences in standards of care across the available guidelines, we critically reviewed all available recent CPGs using the AGREE II tool for the diagnosis, assessment and treatment of non-neurogenic male LUTS.…”