The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

Hatakeyama, Yosuke; Seto, Kanako; Amin, Rebeka; Kitazawa, Takefumi; Fujita, Shigeru; Matsumoto, Kunichika; Hasegawa, Tomonori

doi:10.1186/s12913-019-4532-0

Cited by 11 publications

(16 citation statements)

References 47 publications

(27 reference statements)

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“…Surprisingly, applicability (D5) was not statistically significant. Hatakeyama et al 14 did not report on determinants of CPG use recommendations, so the present findings cannot be compared with theirs. Currently, there is no explanation why the factors determining an overall rating are so dissimilar from those having an impact on CPG use recommendation.…”

Section: Discussioncontrasting

confidence: 73%

“… 7 , 10 , 11 Only Gagliardi and Brouwers 9 in testing the association between domain 5 (Applicability) scores and publication year, country of publication, and type of CPG developer used mixed effect models as appropriate in this situation. (In the case of Hatakeyama et al, 14 there was no need for such modeling because all 206 of their CPGs were evaluated by the same team.)…”

Section: Discussionmentioning

confidence: 99%

“…Rigor had the greatest influence (β = 0.46), followed by clarity (0.19) and applicability (0.16). 14 This clearly is not in line with what Hoffmann-Esser’s respondents thought that they emphasized. Very surprising is also that her respondents gave little weight to applicability, which (at least in rehabilitation and other complex interventions) would seem to be a key CPG quality issue.…”

mentioning

confidence: 82%

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What Determines the Quality of Rehabilitation Clinical Practice Guidelines?

Dijkers

Ward

Annaswamy

et al. 2020

Am J Phys Med Rehabil

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 82%

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What Determines the Quality of Rehabilitation Clinical Practice Guidelines?

Dijkers

Ward

Annaswamy

et al. 2020

Am J Phys Med Rehabil

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“…There is global variation in the development, standardisation, and quality assessment of CPGs; and this heterogeneity has been considered in this and other studies 23,31,42 . This study attempted a global view across different countries and regions.…”

Section: Main Findingsmentioning

confidence: 96%

Advancing guideline quality through country-wide and regional appraisal of CPGs: a scoping review

Allister

Flórez

Stoker

et al. 2022

Preprint

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Background and Objective: Clinical practice guidelines (CPGs) are evaluated for quality with the Appraisal of Guidelines for Research and Evaluation (AGREE) tool(s), and this is increasingly done for different countries and regional groupings. This study aimed to describe, map, and compare these geographical synthesis studies, that assessed CPG quality using the AGREE tool(s). This allowed for a global interpretation of the current landscape of these country-wide or regional quality reviews, and a closer look at their methodology and results. Study design and Methods: A scoping review was conducted searching databases Medline, Embase, Epistemonikos, and grey literature on 5 October 2021 for review studies using the latest AGREE tool(s) to evaluate country-wide or regional CPG quality. Country-wide or regional reviews were the units of analysis, and simple descriptive statistics was used to conduct the analysis. AGREE scores were analysed across subgroups into one of the seven SDG regions, to allow for meaningful interpretation. Results Fifty-seven studies fulfilled our eligibility criteria, including 2918 CPGs. Regions of the Global North, and Eastern and South-East Asia were best represented. Studies were consistent in reporting and presenting their AGREE domain and overall results, but only 18% (n = 10) reported development methods and 19% (n = 11) reported use of GRADE. Overall scores for domains Rigor of development and Editorial independence were low, notably in middle-income countries. There were no reviews from low-income countries. Editorial Independence, especially, were low across all regions with a maximum domain score of 46%. Conclusion There is an increasing tendency to appraise country-wide and regional CPGs using quality appraisal tools, and this will expectantly improve quality of CPGs globally. The AGREE tool(s), evaluated in this study, were used well and consistently across studies. Findings of low report rates of development of CPGs and of use of GRADE is concerning, as is low domain scores globally for Editorial Independence. Transparent reporting of funding and competing interests, as well as highlighting evidence-to-decision processes, should assist in further improving quality as Clinicians (especially those from lower income regions) are in dire need of high-quality guidelines.

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“…Previous studies have applied domain score calculation methods to calculate mean scores for the item 'rate the overall quality of this guideline' without reference to the item 'recommendations of the guideline for use' [23][24] . In others, assessors have scored this based on the average rating given to the six domains [9,25] . In our study we gave no instructions to reviewers about providing overall recommendations.…”

Section: Overall Guideline Assessmentmentioning

confidence: 99%

Critical Appraisal of the National Institute for Health and Care Excellence (NICE) Guidelines for Spine Disorders using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II)

LIANG

Roberts

et al. 2022

Preprint

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Introduction: Disorders of the spine (as defined by the musculoskeletal structures surrounding the spinal neural elements) require an evidence-based, approach to their care. This evaluation used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to evaluate the methodological quality of evidence-based guidelines on spine disorders published by The National Institute for Health and Care Excellence (NICE).Materials and methods: We systematically searched clinical guidelines on spine disorders published by NICE until December 2019. Four appraisers across three international centers independently evaluated the quality of eligible clinical guidelines using AGREE II. Mean AGREE II scores for each domain were calculated. In higher quality domains scores for individual items were analysed. The guidelines were grouped according to type and year of publication. Comparative statistics and intraclass correlation (ICC) calculations were performed.Results: A total of 37 guidelines published by NICE on spine disorders were identified. Mean scores for all six domains were as follows: Scope and Purpose (73.2%), Stakeholder Involvement (63.9%), Rigour of Development (68.1%), Clarity of Presentation (73.6%), Applicability (53.2%) and Editorial Independence (64.5%). The mean score for overall quality of all NICE spinal-related guidelines was 68.8% (95% CI: 62.3–75.3). Interventional Procedure Guidelines were evaluated as possessing significantly lower overall quality than other types (p = 0.007). Overall quality was significantly associated with year of publication (rs=0.476, p = 0.0029). Evaluator ICC for each guideline ranged from 0.39 to 0.95.Conclusions: NICE guidelines on spine disorders demonstrated acceptable or good quality across most domains. Despite deficiencies in the applicability domain, their quality has improved over time. We recommend use of NICE guidelines for assessment and treatment of spine disorders.

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The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

Cited by 11 publications

References 47 publications

What Determines the Quality of Rehabilitation Clinical Practice Guidelines?

What Determines the Quality of Rehabilitation Clinical Practice Guidelines?

Advancing guideline quality through country-wide and regional appraisal of CPGs: a scoping review

Critical Appraisal of the National Institute for Health and Care Excellence (NICE) Guidelines for Spine Disorders using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II)

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