Article type
Abstract
"Background:
Guidelines must be produced through unbiased, transparent, and evidence-based processes to be useful and trustworthy to clinicians and patients making healthcare decisions. The Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool was developed to inform guideline reporting and assess methodological rigor in development. Although often used by third parties for appraisal of published guidelines, AGREE-II can also be used by guideline-producing organizations for internal process planning and ongoing quality improvement. Experienced systematic reviewers are uniquely qualified to identify AGREE-II elements in guidelines/supporting materials and provide objective quality assessments based on a priori criteria.
Objective:
To describe a collaborative process between in-house systematic review (SR) and guideline development (GD) teams using AGREE-II to improve the quality of evidence-based guidelines.
Methods:
As part of program development, our department integrated the skills of our recently formed in-house SR team to assess quality of an internally produced guideline using scoring instructions from AGREE-II. Our SR team met to clarify domain definitions and scoring criteria. Each member reviewed the guideline independently and discussed scores and rationale; after discussion, any change was at each reviewer’s discretion. Minor discords persisted across multiple domains. The SR team presented strengths and improvement recommendations to the GD team.
Results:
The teams collectively identified documentation and process improvements necessary to improve the guideline’s AGREE-II score. The guideline was revised, largely to enhance clarity and more explicitly highlight the link between the evidence and recommendations. We re-assessed the guideline, and scores improved across all domains. To improve future processes and streamline future guidelines, we collaboratively developed a template for guideline documentation, development, and writing following AGREE-II domains. Each team used this iterative process as opportunities to share our areas of expertise, resulting in improved robustness of each team’s processes.
Conclusion:
Beyond a tool to improve guideline reporting, organizations can effectively use AGREE-II to create practices that improve transparency and rigor in the GD process and provide greater communication between GD and SR functions.
"
Guidelines must be produced through unbiased, transparent, and evidence-based processes to be useful and trustworthy to clinicians and patients making healthcare decisions. The Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool was developed to inform guideline reporting and assess methodological rigor in development. Although often used by third parties for appraisal of published guidelines, AGREE-II can also be used by guideline-producing organizations for internal process planning and ongoing quality improvement. Experienced systematic reviewers are uniquely qualified to identify AGREE-II elements in guidelines/supporting materials and provide objective quality assessments based on a priori criteria.
Objective:
To describe a collaborative process between in-house systematic review (SR) and guideline development (GD) teams using AGREE-II to improve the quality of evidence-based guidelines.
Methods:
As part of program development, our department integrated the skills of our recently formed in-house SR team to assess quality of an internally produced guideline using scoring instructions from AGREE-II. Our SR team met to clarify domain definitions and scoring criteria. Each member reviewed the guideline independently and discussed scores and rationale; after discussion, any change was at each reviewer’s discretion. Minor discords persisted across multiple domains. The SR team presented strengths and improvement recommendations to the GD team.
Results:
The teams collectively identified documentation and process improvements necessary to improve the guideline’s AGREE-II score. The guideline was revised, largely to enhance clarity and more explicitly highlight the link between the evidence and recommendations. We re-assessed the guideline, and scores improved across all domains. To improve future processes and streamline future guidelines, we collaboratively developed a template for guideline documentation, development, and writing following AGREE-II domains. Each team used this iterative process as opportunities to share our areas of expertise, resulting in improved robustness of each team’s processes.
Conclusion:
Beyond a tool to improve guideline reporting, organizations can effectively use AGREE-II to create practices that improve transparency and rigor in the GD process and provide greater communication between GD and SR functions.
"