Evaluation of the quality of guidelines for gastric cancer with the AGREE II instrument

Tags: Poster
Hu L1, Guo T1, Yang K2, Yao L3
1Department of general surgery, Gansu Provincial People's Hospital , 2Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 3Department of general surgery, Gansu Provincial People's Hospital

Background:Gastric cancer is the fifth most common cancer, accounting for 951 600 new cases and 723 000 deaths worldwide in 2012. Many countries either lack appropriate clinical practice guidelines (CPGs) of gastric cancer or the quality of their guidelines has never been evaluated.

Objectives:The main objective of our work was to identify published gastric cancer guidelines and assess their quality with the Appraisal of Guidelines for Research and Evaluation instrument II (AGREE II) and their suitability regarding adaptation for future guidelines.

Methods:We performed a systematic literature search on gastric cancer clinical practice guidelines of PubMed, National Guidelines Clearinghouse, the Guidelines International Network, National Institute for Health and Clinical Excellence, and National Comprehensive Cancer Network. Methodological quality of selected guidelines was assessed by the AGREE II instrument.

Results:A total of 541 citations were screened and 15 relevant guidelines were identified. Overall, the guidelines performed well in the clarity and presentation domain with a mean score of 49%, followed by scope and purpose (48%). In contrast, poor scores were given for the remaining domains: stakeholder involvement (32%), editorial independence (32%), rigour of development (29%), and applicability (15%). According to the AGREE II instrument, three guidelines can be strongly recommended; 12 with provisos and alterations while the remaining can’t be recommended for adaptation due to poor methodological quality (especially the guidelines in developing countries).

Conclusions:Although existing gastric cancer guidelines may accurately reflect agreed clinical practice, many guidelines lack proper methodological quality. Future guidelines should place more emphasis on these methodological shortcomings, especially the guidelines in developing countries, in order to effectively guide clinicians in clinical practice.