Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument

2021 ◽  
Vol 103 (7) ◽  
pp. 471-477
Author(s):  
P Gavriilidis ◽  
A Askari ◽  
E Gavriilidis ◽  
N de’Angelis ◽  
S Di Saverio ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Methodological Quality ◽  
Stakeholder Involvement ◽  
German Society ◽  
Cochrane Library ◽  
Agree Ii ◽  
American Society ◽  
General And Visceral Surgery ◽  
Agree Ii Instrument

Introduction Diverticular disease is one of the most frequent reasons for attending emergency departments and surgical causes of hospital admission. In the past decade, many surgical and gastroenterological societies have published guidelines for the management of diverticular disease. The aim of the present study was to appraise the methodological quality of these guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool. Methods PubMed, Embase, Cochrane Library and Google Scholar databases were searched systematically. The methodological quality of the guidelines was appraised independently by five appraisers using the AGREE II instrument. Findings A systematic search of the literature identified 12 guidelines. The median overall score of all guidelines was 68%. Across all guidelines, the highest score of 85% was demonstrated in the domain ‘Scope and purpose’. The domains ‘Clarity and presentation’ and ‘Editorial independence’ both scored a median of 72%. The lowest scores were demonstrated in the domains ‘Stakeholder involvement’ and ‘Applicability’ at 46% and 40%, respectively. Overall, the National Institute for Health and Care Excellence (NICE) guidelines performed consistently well, scoring 100% in five of six domains; NICE was one of the few guidelines that specifically reported stakeholder involvement, scoring 97%. Generally, the domain of ‘Stakeholder involvement’ ranked poorly with seven of twelve guidelines scoring below 50%, with the worst score in this domain demonstrated by Danish guidelines at 25%. Conclusion Six of twelve guidelines (NICE, American Society of Colon & Rectal Surgeons (ASCRS), European Society of Coloproctology (ESCP), American Gastroenterological Association, German Society of Gastroenterology/German Society for General and Visceral Surgery (German), Netherlands Society of Surgery) scored above 70%. Only three, NICE, ASCRS and ESCP, scored above 75% and were voted unanimously by the appraisers for use as they are. Therefore, use of AGREE II may help improve the methodological quality of guidelines and their future updates.

scholarly journals The quality of guidelines in non-pharmacological prevention and management of chemotherapy-induced neuropathy: A review

2018 ◽  
Author(s):  
Shahin Salarvand ◽  
Simin Hemati ◽  
Payman Adibi ◽  
Fariba Taleghani
Keyword(s):  
Methodological Quality ◽  
Stakeholder Involvement ◽  
Common Adverse Effect ◽  
Adaptation Process ◽  
Medical Sciences ◽  
High Quality ◽  
Agree Ii ◽  
Pharmacological Prevention ◽  
Agree Ii Instrument

Chemotherapy-induced peripheral neuropathy is a common adverse effect occurring in patients undergoing neurotoxic chemotherapy. However, there is no FDA-approved treatment option for it. Given the importance of clinical practice guidelines in this area, this study aimed to determine the methodological quality of extant CIPN guidelines. The study was done as part of the adaptation process of CIPN related CPGs at Isfahan University of Medical Sciences, Iran. A systematic search of published CPGs about chemotherapy-induced CIPN in which the AGREE II instrument was applied for appraising CPGs of CIPN was performed. In general, amongst all of the AGREE II Instrument’s domains in the evaluated CPGs, the clarity of presentation and stakeholder involvement domains took favorable scores; and other domains obtained unfavorable and relatively favorable scores. The quality of cancer therapy-induced neuropathy CPGs needs to be improved and designing high-quality CPGs must be considered.

scholarly journals Management in the paediatric wards facing novel coronavirus infection: a rapid review of guidelines and consensuses

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039897
Author(s):  
Wen-Yi Luo ◽  
Ji-Wen Sun ◽  
Wen-Lan Zhang ◽  
Qian Li ◽  
Ping Ni ◽  
...  
Keyword(s):  
Control Strategies ◽  
Stakeholder Involvement ◽  
Rapid Review ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Agree Ii ◽  
Relevant Evidence ◽  
And Control ◽  
Agree Ii Tool

ObjectivesRelevant guidelines and consensuses for COVID-19 contain recommendations aimed at optimising the management in paediatric wards. The goal of this study was to determine the quality of those recommendations and provide suggestions to hospital managers for the adjustment of existing hospital prevention and control strategies, and also to offer recommendations for further research.DesignA rapid review of the guidelines and consensuses for the management in paediatric wards facing COVID-19.MethodsPubMed, EMBASE, the Cochrane Library, UpToDate, China National Knowledge Infrastructure, the Wanfang database and relevant websites such as medlive.cn, dxy.cn, the National Health and Health Commission and the China Center for Disease Control and Prevention were systematically searched through late May 2020. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was then used to assess the quality of the selected articles and summarise the relevant evidence concerning management in paediatric wards.ResultsA total of 35 articles were included, composed of 3 consensus guidelines, 25 expert consensuses and 7 expert opinions. Of the 35 papers, 24 were from China, 2 from the USA, 1 from Spain, 1 from Brazil, 1 from Saudi Arabia and 6 from multinational cooperative studies. Scores for the six domains of the AGREE II tool (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) were 98.57%, 53.57%, 17.92%, 69.62%, 26.96% and 50.35%, respectively. Recommendations for nosocomial infection and control, human resource management as well as management of paediatric patients and their families were summarised.ConclusionsDue to the outbreak of COVID-19, the quality of rapid guidelines and consensuses for the management in paediatric wards affected by COVID-19 is unsatisfactory. In the future, it will be necessary to develop more high-quality guidelines or consensuses for the management in paediatric wards to deal with nosocomial outbreaks in order to fully prepare for emergency medical and health problems.

scholarly journals Applicability of the AGREE II Instrument in Evaluating the Development Process and Quality of Current National Academy of Clinical Biochemistry Guidelines

2012 ◽  
Vol 58 (10) ◽  
pp. 1426-1437 ◽  
Author(s):  
Andrew C Don-Wauchope ◽  
John L Sievenpiper ◽  
Stephen A Hill ◽  
Alfonso Iorio
Keyword(s):  
Clinical Laboratory ◽  
Clinical Biochemistry ◽  
Guideline Development ◽  
Stakeholder Involvement ◽  
Laboratory Medicine ◽  
Quality Of Reporting ◽  
Agree Ii ◽  
Strongly Agree ◽  
Agree Ii Instrument

Abstract BACKGROUND Laboratory medicine practice guidelines (LMPGs) are an important part of clinical laboratory medicine. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument has been developed to evaluate the process of practice-guideline development and the quality of reporting. We assessed the applicability of AGREE II in assessing the National Academy of Clinical Biochemistry (NACB) LMPGs. METHODS The NACB website was searched for all available LMPGs up to December 2011. Two independent appraisers used the AGREE II instrument to assess each LMPG identified by the search. Quality was assessed across 6 domains (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence), comprising a total of 23 items and 2 overall assessments, each scored on a 7-point scale (1, strongly disagree, to 7, strongly agree). All scores were expressed as AGREE II calculated percentages (100% indicates that all items scored 7 by all appraisers). RESULTS Eleven LMPGs were identified. All of the LMPGs provided some information seen as applicable to clinical practice by the appraisers. Only 5 of the LMPGs had overall scores ≥50%, with a median score of 42% (range: 8%–92%). Individual domain scores varied considerably from 0% to 100%. One guideline achieved a very high score on the instrument. CONCLUSIONS The AGREE II instrument is applicable and useful to evaluate LMPGs. All domains were evaluated as being useful to assess LMPGs, some were addressed well (e.g., clarity of presentation), whereas others could be improved (e.g., applicability).

scholarly journals Methodological Quality Assessment with the AGREE II Scale and A Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 972
Author(s):  
Steve Nguala ◽  
Elisabeth Baux ◽  
Solène Patrat-Delon ◽  
Florian Saunier ◽  
Julien Schemoul ◽  
...  
Keyword(s):  
Lyme Borreliosis ◽  
Methodological Quality ◽  
Stakeholder Involvement ◽  
Weighted Kappa ◽  
Agree Ii ◽  
High Agreement ◽  
Effective Doses ◽  
National Databases ◽  
Comparative Trials

Background: Most European and American countries recently updated their guidelines on Lyme borreliosis (LB). The aim of this study was to provide a comparative overview of existing guidelines on the treatment of LB in Europe and America and to assess the methodological quality of their elaboration. Methods: A systematic search was carried out in MEDLINE, Google Scholar, and the national databases of scientific societies from 2014 to 2020. Quality was assessed by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Results: Twelve guidelines were included. The scores for the AGREE II domains (median ± IQR) were: overall assessment 100 ± 22, scope and purpose 85 ± 46, stakeholder involvement 88 ± 48, rigour of development 67 ± 35, clarity of presentation 81 ± 36, applicability 73 ± 52 and editorial independence 79% ± 54%. Cohen’s weighted kappa showed a high agreement (K = 0.90, 95%CI 0.84–0.96). Guidelines were quite homogeneous regarding the recommended molecules (mostly doxycycline in the first intention and ceftriaxone in the second intention), their duration (10 to 28 days), and their dosage. The differences were due to the lack of well-conducted comparative trials. The International Lyme and Associated Diseases Society (ILADS) guidelines were the only ones to suggest longer antibiotics based on an expert consensus. Conclusion: European and American guidelines for the treatment of LB were quite homogeneous but based on moderate- to low-evidence studies. Well-conducted comparative trials are needed to assess the best molecules, the optimal duration and the most effective doses.

scholarly journals A Critical Appraisal of Evidence- and Consensus-Based Guidelines for Actinic Keratosis

2021 ◽  
Vol 28 (1) ◽  
pp. 950-960
Author(s):  
Anja Wessely ◽  
Theresa Steeb ◽  
Franz Heppt ◽  
Annkathrin Hornung ◽  
Matthias D. Kaufmann ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Treatment Options ◽  
Stakeholder Involvement ◽  
Agree Ii ◽  
Canadian Guideline ◽  
The United Kingdom ◽  
Appropriate Treatment ◽  
The Relationship ◽  
Spearman’S Correlation

Actinic keratoses (AK) are common lesions of the skin that can be effectively treated with several lesion- and field-directed treatments. Clinical practice guidelines assist physicians in choosing the appropriate treatment options for their patients. Here, we aimed to systematically identify and evaluate the methodological quality of currently available guidelines for AK. Guidelines published within the last 5 years were identified in a systematic search of guideline databases, Medline and Embase. Then, six independent reviewers evaluated the methodological quality using the tools “Appraisal of Guidelines for Research and Evaluation” (AGREE II) and “Recommendation EXcellence” (AGREE-REX). The Kruskal–Wallis (H) test was used to explore differences among subgroups and Spearman’s correlation to examine the relationship between individual domains. Three guidelines developed by consortia from Canada, Germany and the United Kingdom were eligible for the evaluation. The German guideline achieved the highest scores, fulfilling 65 to 92% of the criteria in AGREE II and 67 to 84% in AGREE-REX, whereas the Canadian guideline scored 31 to 71% of the criteria in AGREE II and 33 to 46% in AGREE-REX. The domains “stakeholder involvement“ and “values and preferences“ were identified as methodological weaknesses requiring particular attention and improvement in future guideline efforts.

scholarly journals Assessing methodological quality of Russian clinical practice guidelines and introducing AGREE II instrument in Russia

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0203328 ◽  
Author(s):  
Dina Ayratova Lienhard ◽  
Lidiya Vacheslavovna Kisser ◽  
Liliya Eugenevna Ziganshina
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Agree Ii ◽  
Agree Ii Instrument

scholarly journals Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation

JRSM Open ◽  
2017 ◽  
Vol 8 (2) ◽  
pp. 205427041668267 ◽  
Author(s):  
Mahmoud Radwan ◽  
Ali Akbari Sari ◽  
Arash Rashidian ◽  
Amirhossein Takian ◽  
Sanaa Abou-Dagga ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Methodological Quality ◽  
Arabic Version ◽  
Agree Ii ◽  
Agree Ii Instrument ◽  
Methodological Evaluation

Objectives To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Design Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Setting Palestinian Primary Healthcare Centres. Participants Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Main outcome measures Methodological quality of diabetic guideline. Results The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach’s α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains ‘Scope and Purpose’ and ‘Clarity of Presentation’ had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for ‘Applicability’, ‘Stakeholder Involvement’, ‘Rigour of Development’ and ‘Editorial Independence’ were the lowest (27%, 35%, 36.5%, and 40%, respectively). Conclusions The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group.

scholarly journals The quality of clinical practice guidelines for preoperative care using the AGREE II instrument: a systematic review

2020 ◽  
Author(s):  
Agustín Ciapponi ◽  
Tapia-López Elena ◽  
Virgilio Sacha ◽  
Ariel Bardach
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cochrane Library ◽  
Agree Ii ◽  
Quality Of Evidence ◽  
Moderate Quality ◽  
Agree Ii Instrument

Abstract Background: Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs). Methods: Systematic review of clinical practice guidelines. Data sources: PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence and strength of recommendations according to the GRADE methodology.Results: We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last five years and seven used GRADE. The median (percentile 25-75) AGREE-II scores for rigor of development was 49% (35-76%) and the domain ‘applicability’ obtained the worst score: 16% (9-31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. ‘Guidelines’ applicability’ and ‘monitoring’ were the most deficient domains. Only half of the EB-CPGs were updated in the past five years. Conclusions: We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines’ quality.

scholarly journals The quality of clinical practice guidelines for preoperative care using the AGREE II instrument: a systematic review

2020 ◽  
Author(s):  
Agustín Ciapponi ◽  
Tapia-López Elena ◽  
Virgilio Sacha ◽  
Ariel Bardach
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cochrane Library ◽  
Agree Ii ◽  
Quality Of Evidence ◽  
Moderate Quality ◽  
Agree Ii Instrument

Abstract Background: Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs). Methods: Systematic review of clinical practice guidelines. Data sources: PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence and strength of recommendations according to the GRADE methodology.Results: We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last five years and seven used GRADE. The median (percentile 25-75) AGREE-II scores for rigor of development was 49% (35-76%) and the domain ‘applicability’ obtained the worst score: 16% (9-31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. ‘Guidelines’ applicability’ and ‘monitoring’ were the most deficient domains. Only half of the EB-CPGs were updated in the past five years. Conclusions: We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines’ quality.

scholarly journals Evaluation of the current guidelines for antibacterial therapy strategies in patients with cirrhosis or liver failure

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuzhu Dong ◽  
Dan Sun ◽  
Yan Wang ◽  
Qian Du ◽  
Ying Zhang ◽  
...  
Keyword(s):  
Liver Failure ◽  
Methodological Quality ◽  
Bacterial Resistance ◽  
Treatment Strategies ◽  
Empirical Treatment ◽  
Agree Ii ◽  
First Choice ◽  
Agree Ii Instrument ◽  
Domain 4

Abstract Background Bacterial infections are common complications in patients with cirrhosis or liver failure and are correlated with high mortality. Clinical practice guideline (CPG) is a reference used to help clinicians make decisions. This systematic appraisal aimed to evaluate the methodological quality and summarize the recommendations of reported CPGs in these patients. Methods We systematically searched CPGs published from 2008 to 2019. The methodological quality of the included CPGs was assessed using the AGREE II instrument. We extracted and compared recommendations for prophylactic and empirical treatment strategies. Results Fourteen CPGs with a median overall score of 56.3% were included. The highest domain score was Clarity of Presentation (domain 4, 85.4%), and the lowest was for Stakeholder Involvement (domain 2, 31.3%). Three CPGs had an overall score above 80%, and 6 CPGs had a score above 90% in domain 4. Prophylaxis should be strictly limited to patients with varicose bleeding, low ascites protein levels and a history of spontaneous bacterial peritonitis. Fluoroquinolones (norfloxacin and ciprofloxacin), third-generation cephalosporins (G3) (ceftriaxone and cefotaxime) and trimethoprim–sulfamethoxazole (SXT) are recommended for preventing infections in patients with cirrhosis or liver failure. G3, β-lactam/β-lactamase inhibitor combinations (BLBLIs) and carbapenems are recommended as the first choice in empirical treatment according to local epidemiology of bacterial resistance. Conclusions The methodological quality of CPGs focused on patients with cirrhosis or liver failure evaluated by the AGREE II instrument is generally poor. Three CPGs that were considered applicable without modification and 6 CPGs that scored above 90% in domain 4 should also be paid more attention to by healthcare practitioners. Regarding recommendations, norfloxacin, ciprofloxacin, ceftriaxone, cefotaxime, and SXT are recommended for prophylactic treatment appropriately. G3, BLBLIs, and carbapenems are recommended for use in empirical treatment strategies.

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