Evaluation of the practice guidelines of Finnish Institute of Occupational Health with AGREE instrument.

Guidelines for occupational physicians are increasing in number. Their quality and content is varied and they may even provide conflicting recommendations. Earlier studies show that guidelines directed at professionals in occupational health use scientific evidence unsystematically or inadequately. This article assesses the guidelines of the Finnish Institute of Occupational Health (FIOH). We selected a random sample of 29 guidelines from all those published by FIOH, which were assessed by four people individually using the AGREE instrument. The items were scored in six domains: scope and purpose of the guideline, stakeholder involvement, rigour of guideline development, clarity and presentation, application, and editorial independence. Mean domain scores were calculated according to AGREE instructions. The guidelines presented their scope and purpose well; the mean domain score was 62%. Their clarity and presentation was fairly good, mean domain score 47%. The stakeholder involvement's mean domain score was 33%. The other domains scored low: applicability domain, 15%, rigour of guideline development, 9%, and editorial independence, 7% only. The rigour and reporting of guideline development seems to be the main challenge for future guideline production in FIOH. A common structure for guideline preparation is needed.