IntroductionPeripheral arterial disease (PAD) is the third leading atherosclerotic arterial disease. There is evidence that there is a high variation in the quality and recommendations of clinical practice guidelines for PAD, leading to the possibility of confusion among clinicians and patients. This study aims to conduct a quality assessment and comparative analysis of the clinical practice guidelines on PAD written between 2010 and 2020.Method and analysisWe aim to perform a systematic review of clinical practice guidelines written between 2010 and 2020. A search for guidelines will be conducted through medical databases Scope, Pubmed, TRIP, Guideline Clearinghouses and specialist international organisations’ specific websites. Guidelines that meet the inclusion criteria will be extracted from the search result. The Appraisal of Guidelines for Research and Evaluation II (AGREE-II instrument) will assess the quality of the selected guidelines. The recommendations, level of evidence and other relevant information will be extracted in a datasheet for qualitative analysis. The score for each guideline’s quality will be represented using charts and central tendency measures for comparison. The summary of recommendations will also be represented in tables for easy comparison for similarities and variations across sections. Finally, the level of evidence on which the recommendations are based will also be noted along with other significant characteristics such as the authors’ financial relationship to the biomedical community. We aim to point out deficiencies present in current guidelines and elucidate areas where recommendations are made with low-level evidence. The results will enable the scientific community to design future research to fill in PAD management knowledge gaps.Ethics and disseminationNo ethical approval was sought. Dissemination will be via journal articles and conference presentations.PROSPERO registration numberCRD42020219176.

ObjectivesThere are several clinical practice guidelines available for peripheral artery disease (PAD). The paucity of strong evidence is known to give room for variations in recommendations across guidelines, with attendant confusion among clinicians in clinical practice. This study aims to conduct a quality assessment and comparative analysis on PAD screening and diagnostic recommendations in PAD management.SelectionClinical practice guidelines written after 2010 and on or before 2020 were targeted. An exhaustive search was conducted through the major medical databases and websites of specialist international organisations of interest, and selection was made using our inclusion/exclusion criteria.SettingGlobal. All guidelines written in English were included in this study.Selected guidelinesNine guidelines were selected.OutcomesThe primary outcomes were the guidelines’ quality and variations in screening and diagnostic recommendations in the selected guidelines.ResultsRegarding quality, the guidelines had the lowest scores across the applicability and stakeholder involvement domains with means (SD) of 62 (9.9) and 65.3 (13), respectively. The highest score was clarity of presentation, with a mean (SD) of 86.8 (5.1). Also, the trend showed guideline quality scores improved over time. The guidelines unanimously offered to screen ‘high-risk’ patients, although there were some discrepancies in the appropriate age range and unavailability of strong evidence backing this recommendation. The guidelines harmoniously adopted the Ankle-Brachial Index as the initial diagnostic investigation of choice. However, concerning further diagnostic investigations and imaging, we found several discrepancies among the recommendations in the absence of strong evidence.ConclusionThough the quality of the guidelines is shown to be improving over time, they perform poorly in stakeholder involvement and applicability domains, which could be influencing interest in research revolving around screening and diagnostic recommendations. Involving primary care providers and the public can be a possible solution.PROSPERO registration numberCRD42020219176.

Introduction: Peripheral Artery Disease (PAD) is a major atherosclerotic disease, and there are several clinical practice guidelines available for it. The paucity of strong evidence is known to give room for variations in recommendations across guidelines with attendant confusion amongst clinicians in clinical practice. This study aims to conduct a quality assessment and comparative analysis on PAD screening and diagnostic recommendations in the management of PAD. Methods: We conducted a systematic review of CPGs' written after 2010 and on or before 2020. An exhaustive search was conducted through the major medical databases and websites of specialist international organisations of interest and using our inclusion criteria, the appropriate guidelines were extracted. The AGREE-II instrument was used for quality assessment, while the recommendations across screening and diagnosis were extracted and then comparatively analysed. Results: We found nine guidelines that fit our criteria. The guidelines had the lowest scores across the applicability and stakeholder involvement domains. The highest scores were recorded in the Clarity of presentation, Scope and purpose and Editorial independence in order of decreasing magnitude. Also, the trend was the guideline quality scores improved over time. The guidelines were unanimous in offering to screen to 'high-risk 'patients, although there were some discrepancies in the appropriate age range and unavailability of strong evidence across the guidelines backing this recommendation. The guidelines also showed harmony in adopting the Ankle-Brachial index as the initial diagnostic investigation of choice. However, concerning further diagnostic investigations and imaging, we found several discrepancies among the recommendations in the absence of strong evidence. Conclusion: Though the quality of the guidelines is shown to be improving over time, they display poor scores in the stakeholder involvement and applicability domains, which could be influencing low interest in research that can improve screening and diagnostic recommendations.