Article type
Abstract
Background
Clinical practice guidelines (CPGs) play a significant role in enhancing healthcare quality. The Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument, with 23 items across 6 domains and 2 overall assessment items, is important for CPG evaluation. While prior studies have explored trends in CPG quality using the AGREE II instrument, emphasis has primarily been on domain scores, with limited attention to item scores.
Objectives
To elucidate trends in item scores of the AGREE II instrument in Japan.
Methods
All Japanese CPGs published from 2011 to 2022 were collected, and independently evaluated by three appraisers using AGREE II instrument. The item scores were calculated as the mean of the three appraisers’ ratings, which range from 1 (Strongly disagree) to 7 (Strongly agree). The time trends in item scores of these CPGs were assessed using the Spearman’s rank correlation coefficients. Items were divided into four categories according to their scores in 2011 being above or below the average for all items (high vs. low), and whether the trend was increasing or decreasing (or not changing) (increasing vs. not-increasing).
Results
A total of 621 CPGs was included and evaluated. Mean item score in 2011 was 4.81. Coefficients were ranging from -0.365 to 0.258. Number of items with high scores and increasing trends was 1, high and not-increasing was 10, low and increasing was 7, and low and not-increasing was 5. Low and not-increasing items were “The views and preferences of the target population (patients, public, etc.) have been sought”, “The criteria for selecting the evidence are clearly described”, “The strengths and limitations of the body of evidence are clearly described”, “A procedure for updating the guideline is provided”, and “The guideline presents monitoring and/or auditing criteria”.
Conclusions
It is understandable that most items with high scores showed a trend of not increasing, suggesting that these items are already widely accepted. Item with low scores and lack of increase in trends may indicate areas where additional support is needed to improve the quality of CPGs.
Clinical practice guidelines (CPGs) play a significant role in enhancing healthcare quality. The Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument, with 23 items across 6 domains and 2 overall assessment items, is important for CPG evaluation. While prior studies have explored trends in CPG quality using the AGREE II instrument, emphasis has primarily been on domain scores, with limited attention to item scores.
Objectives
To elucidate trends in item scores of the AGREE II instrument in Japan.
Methods
All Japanese CPGs published from 2011 to 2022 were collected, and independently evaluated by three appraisers using AGREE II instrument. The item scores were calculated as the mean of the three appraisers’ ratings, which range from 1 (Strongly disagree) to 7 (Strongly agree). The time trends in item scores of these CPGs were assessed using the Spearman’s rank correlation coefficients. Items were divided into four categories according to their scores in 2011 being above or below the average for all items (high vs. low), and whether the trend was increasing or decreasing (or not changing) (increasing vs. not-increasing).
Results
A total of 621 CPGs was included and evaluated. Mean item score in 2011 was 4.81. Coefficients were ranging from -0.365 to 0.258. Number of items with high scores and increasing trends was 1, high and not-increasing was 10, low and increasing was 7, and low and not-increasing was 5. Low and not-increasing items were “The views and preferences of the target population (patients, public, etc.) have been sought”, “The criteria for selecting the evidence are clearly described”, “The strengths and limitations of the body of evidence are clearly described”, “A procedure for updating the guideline is provided”, and “The guideline presents monitoring and/or auditing criteria”.
Conclusions
It is understandable that most items with high scores showed a trend of not increasing, suggesting that these items are already widely accepted. Item with low scores and lack of increase in trends may indicate areas where additional support is needed to improve the quality of CPGs.