AGREE II: Advancing guideline development, reporting, and evaluation in health care

Brouwers, Melissa; Kho, Michelle E.; Browman, George P.; Burgers, Jako; Cluzeau, Françoise; Feder, Gene; Fervers, Béatrice; Graham, Ian D.; Grimshaw, Jeremy; Hanna, Steven; Littlejohns, Peter; Makarski, Julie; Zitzelsberger, Louise

doi:10.1016/j.ypmed.2010.08.005

Cited by 678 publications

(922 citation statements)

References 11 publications

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“…15 The AGREE Instrument was originally developed by a group of international guideline developers and researchers [15][16][17] and published in 2003 to appraise the quality of guidelines. The original AGREE Instrument included 23 items categorized into 6 quality domains.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…The original AGREE Instrument included 23 items categorized into 6 quality domains. [15][16][17] The measure has been translated into multiple languages and has been cited in .100 publications. 17 An updated version, the AGREE II, published in 2009, 16 included a new user' s manual and revisions of 12 items from the original AGREE instrument.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…A complete list of specific changes from the original AGREE Instrument is available in a separate article. 15 In addition, scaling of responses in the AGREE has been changed from a 4-point to a 7-point Likert scale, which may influence the process of scoring clinical practice guideline evaluations.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…2,3 Guidelines are defined as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." 15 Over the past decade, numerous pediatric pain practice guidelines have been developed; however, little is known about the methodological quality of these guidelines. The purpose of this systematic review was to evaluate the quality of existing pediatric clinical practice guidelines on acute procedural pain and to provide recommendations for their use in clinical practice.…”

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confidence: 99%

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

et al. 2014

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BACKGROUND: Procedural pain assessment and management have been extensively studied through multiple research studies over the past decade. Results of this research have been included in numerous pediatric pain practice guidelines. OBJECTIVE:To systematically review the quality of existing practice guidelines for acute procedural pain in children and provide recommendations for their use. METHODS:A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, and Scopus from 2000 to July 2013. A gray literature search was also conducted through the Translating Research Into Practice database, Guidelines International Network database, and National Guideline Clearinghouse. Four reviewers rated relevant guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Screening of guidelines, assessment of methodological quality, and data abstraction were conducted by 2 pairs of raters. Disagreements in overall assessments were resolved through consensus. RESULTS:Eighteen guidelines from 4930 retrieved abstracts were included in this study. Based on the AGREE II domains, the guidelines generally scored high in the scope and purpose and clarity of presentation areas. Information on the rigor of guideline development, applicability, and editorial independence were specified infrequently. Four of the 18 guidelines provided tools to help clinicians apply the recommendations in practice settings; 5 were recommended for use in clinical settings, and the remaining 13 were recommended for use with modification. CONCLUSIONS:Despite the increasing availability of clinical practice guidelines for procedural pain in children, the majority are of average quality. More transparency and comprehensive reporting are needed for the guideline development process. Pediatrics 2014;133:500-515

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Section: Quality Assessmentmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

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

et al. 2014

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“…We have not assessed the guidelines’ methodological rigour and transparency by using tools such as the Agree II99 or other instruments. Our main interest was to identify the individual interventions considered in these documents so that important or relevant manoeuvres, tests and procedures were not omitted.…”

Section: Discussionmentioning

confidence: 99%

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

Ábalos

Chamillard

Díaz

et al. 2015

BJOG

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BackgroundThe World Health Organization (WHO) is in the process of updating antenatal care (ANC) guidelines.ObjectivesTo map the existing clinical practice guidelines related to routine ANC for healthy women and to summarise all practices considered during routine ANC.Search strategyA systematic search in four databases for all clinical practice guidelines published after January 2000.Selection criteriaTwo researchers independently assessed the list of potentially eligible publications.Data collection and analysisInformation on scope of the guideline, type of practice, associated gestational age, recommendation type and the source of evidence were mapped.Main resultsOf 1866 references, we identified 85 guidelines focusing on the ANC period: 15 pertaining to routine ANC and 70 pertaining to specific situations. A total of 135 interventions from routine ANC guidelines were extracted, and categorised as clinical interventions (n = 80), screening/diagnostic procedures (n = 47) and health systems related (n = 8). Screening interventions, (syphilis, anaemia) were the most common practices. Within the 70 specific situation guidelines, 102 recommendations were identified. Overall, for 33 (out of 171) interventions there were conflicting recommendations provided by the different guidelines.ConclusionMapping the current guidelines including practices related to routine ANC informed the scoping phase for the WHO guideline for ANC. Our analysis indicates that guideline development processes may lead to different recommendations, due to context, evidence base or assessment of evidence. It would be useful for guideline developers to map and refer to other similar guidelines and, where relevant, explore the discrepancies in recommendations and others.Tweetable abstractWe identified existing ANC guidelines and mapped scope, practices, recommendations and source of evidence.

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Follow-up of Patients With Keratinocyte Carcinoma

et al. 2023

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ImportancePatients treated for cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), collectively called keratinocyte carcinoma (KC), are at risk for recurrence, metastasis, and additional primary cutaneous malignant neoplasms. It is unclear how often patients should be seen for follow-up skin examination after initial treatment of KC.ObjectiveTo summarize the recommendations and evaluate the methodological quality of clinical practice guidelines for dermatologic follow-up of patients with BCC and invasive SCC.Evidence ReviewPubMed, MEDLINE, and Embase were searched for relevant articles published from January 2010 to March 2022. Search terms included guideline, squamous cell carcinoma, and basal cell carcinoma. National or international guidelines containing recommendations for follow-up frequency after a diagnosis of localized cutaneous KC were included. Quality was assessed using the 6 domains of the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool: (1) scope and purpose; (2) stakeholder development; (3) rigor of development; (4) clarity of presentation; (5) applicability; and (6) editorial independence. The Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) was used to guide study reporting.FindingsAmong the 14 guidelines meeting eligibility criteria, there was little consensus on the appropriate follow-up frequency after initial KC treatment. Overall duration of follow-up ranged from a single posttreatment visit to lifelong surveillance. Most guidelines stratified their recommendations by recurrence risk. For low-risk BCC and guidelines that did not stratify by risk, follow-up recommendations ranged from every 6 to 12 months. For high-risk BCC, 1 guideline suggested follow-up every 3 months, while 4 recommended every 6 months. For low-risk SCC, 5 guidelines recommended annual follow-up; 3 guidelines, every 6 months; and 1 guideline, every 3 months. For high-risk SCC, recommendations included a range of follow-up frequencies, spanning every 3 months (n = 5 guidelines), 4 months (n = 1), 6 months (n = 6), or annually (n = 4). One guideline did not use risk stratification and recommended annual screening. The highest scoring AGREE II domain was “scope and purpose,” which assessed the guideline’s overall objectives, and the lowest scoring was “applicability,” which assessed barriers and facilitators to implementation.Conclusions and RelevanceThe findings of this systemic review highlight variations in follow-up recommendations for patients after initial treatment for KC. Randomized clinical trials are needed to define an optimal follow-up regimen.

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AGREE II: Advancing guideline development, reporting, and evaluation in health care

Cited by 678 publications

References 11 publications

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

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

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

Follow-up of Patients With Keratinocyte Carcinoma

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