Wiebke Hoffmann-Eßer1, Ulrich Siering2, Edmund A M Neugebauer3, Ulrike Lampert2, Michaela Eikermann4. 1. Department Healthcare and Health Economy, Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany; Faculty of Health, Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Campus Cologne, Cologne, Germany. Electronic address: wiebke.hoffmann-esser@iqwig.de. 2. Department Healthcare and Health Economy, Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany. 3. Brandenburg Medical School-Theodor Fontane, Neuruppin, Germany; Faculty of Health, University of Witten/Herdecke, Witten/Herdecke, Germany. 4. Department of Evidence Based Medicine, Medical Advisory Service of the German Social Health Insurance (MDS), Essen, Germany.
Abstract
OBJECTIVES: To investigate whether Appraisal of Guidelines for Research & Evaluation (AGREE) II users apply a cut-off based on standardized domain scores or overall guideline quality to distinguish between high- and low-quality guidelines, as well as to investigate which criteria they use to generate this cut-off and which type of cut-off they apply. STUDY DESIGN AND SETTING: We conducted a systematic search in MEDLINE, EMBASE, DARE, and the HTA-database for German- and English-language studies appraising guidelines with AGREE II. Information on cut-offs was extracted and analyzed descriptively. RESULTS: We identified 118 relevant publications. Thirty-nine (33%) used a cut-off, of which 24 (62%) used a 2-step and 13 (33%) used a 3-step approach. The cut-off for high quality lay between 50% and 70% (2-step) and 60% and 83% (3-step) of the highest possible rating. Twenty-four (62%) publications applied a cut-off based on standardized domain scores and 7 (18%) based on overall guideline quality. Eleven (28%) applied cut-offs to derive the recommendation for guideline use. CONCLUSION: A third of AGREE II users apply a cut-off to distinguish between high- and low-quality guidelines, often without clearly describing how the cut-off is generated. Many users might welcome a clear distinction between high- and low-quality guidelines; specifying a cut-off for this purpose might be useful.
OBJECTIVES: To investigate whether Appraisal of Guidelines for Research & Evaluation (AGREE) II users apply a cut-off based on standardized domain scores or overall guideline quality to distinguish between high- and low-quality guidelines, as well as to investigate which criteria they use to generate this cut-off and which type of cut-off they apply. STUDY DESIGN AND SETTING: We conducted a systematic search in MEDLINE, EMBASE, DARE, and the HTA-database for German- and English-language studies appraising guidelines with AGREE II. Information on cut-offs was extracted and analyzed descriptively. RESULTS: We identified 118 relevant publications. Thirty-nine (33%) used a cut-off, of which 24 (62%) used a 2-step and 13 (33%) used a 3-step approach. The cut-off for high quality lay between 50% and 70% (2-step) and 60% and 83% (3-step) of the highest possible rating. Twenty-four (62%) publications applied a cut-off based on standardized domain scores and 7 (18%) based on overall guideline quality. Eleven (28%) applied cut-offs to derive the recommendation for guideline use. CONCLUSION: A third of AGREE II users apply a cut-off to distinguish between high- and low-quality guidelines, often without clearly describing how the cut-off is generated. Many users might welcome a clear distinction between high- and low-quality guidelines; specifying a cut-off for this purpose might be useful.
Authors: Yasser S Amer; Maher A Titi; Mohammad W Godah; Hayfaa A Wahabi; Layal Hneiny; Manal Mohamed Abouelkheir; Muddathir H Hamad; Ghada Metwally ElGohary; Mohamed Ben Hamouda; Hella Ouertatani; Pamela Velasquez-Salazar; Jorge Acosta-Reyes; Samia M Alhabib; Samia Ahmed Esmaeil; Zbys Fedorowicz; Ailing Zhang; Zhe Chen; Sarah Jayne Liptrott; Niccolò Frungillo; Amr A Jamal; Sami A Almustanyir; Newman Ugochukwu Dieyi; John Powell; Katrina J Hon; Rasmieh Alzeidan; Majduldeen Azzo; Sara Zambrano-Rico; Paulina Ramirez-Jaramillo; Ivan D Florez Journal: J Clin Epidemiol Date: 2021-11-14 Impact factor: 6.437