Stavros A Antoniou1,2, Ivan D Florez3,4, Sheraz Markar5,6, Patricia Logullo7, Manuel López-Cano8, Gianfranco Silecchia9, George A Antoniou10,11, Sofia Tsokani12, Dimitrios Mavridis12,13, Melissa Brouwers3. 1. Department of Surgery, Mediterranean Hospital of Cyprus, Limassol, Cyprus. stavros.antoniou@hotmail.com. 2. European University Cyprus, Nicosia, Cyprus. stavros.antoniou@hotmail.com. 3. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. 4. Department of Pediatrics, University of Antioquia, Medellin, Colombia. 5. Nuffield Department of Surgery, University of Oxford, Oxford, UK. 6. Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden. 7. UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK. 8. Abdominal Wall Surgery Unit, Val d' Hebrón University Hospital, Universidad Autónoma de Barcelona, Barcelona, Spain. 9. Department of Medico-Surgical Sciences and Translation Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy. 10. Department of Vascular and Endovascular Surgery, Manchester University NHS Foundation Trust, Manchester, UK. 11. Division of Cardiovascular Sciences, School of Medical Sciences, The University of Manchester, Manchester, UK. 12. Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece. 13. Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
Abstract
BACKGROUND: The Appraisal of Guidelines Research and Evaluation (AGREE) II instrument was developed to evaluate the quality of clinical practice guidelines. Evidence suggests that development, reporting, and appraisal of guidelines on surgical interventions may be better informed by modification of the instrument. OBJECTIVE: We aimed to develop an AGREE II extension specifically designed for appraisal of guidelines of surgical interventions. METHODS: In a three-part project funded by the United European Gastroenterology and the European Association for Endoscopic Surgery, (i) we identified factors that were associated with higher quality of surgical guidelines, (ii) we statistically calibrated the AGREE II instrument in the context of surgical guidelines using correlation, reliability, and factor analysis, and (iii) we undertook a Delphi consensus process of stakeholders to inform the development of an AGREE II extension instrument for surgical interventions. RESULTS: Several features were prioritized by stakeholders as of particular importance for guidelines of surgical interventions, including development of a guideline protocol, consideration of practice variability and surgical expertise in different settings, and specification of infrastructures required to implement the recommendations. The AGREE-S-AGREE II extension instrument for surgical interventions has 25 items, compared to the 23 items of the original AGREE II instrument, organized into the following 6 domains: Scope and purpose, Stakeholders, Evidence synthesis, Development of recommendations, Editorial independence, and Implementation and update. As the original instrument, it concludes with an overall appraisal of the quality of the guideline and a judgement on whether the guideline is recommended for use. Several items were amended and rearranged among domains, and an item was deleted. The Rigor of Development domain of the original AGREE II was divided into Evidence Synthesis and Development of Recommendations. Items of the AGREE II domain Clarity of Presentation were incorporated in the new domain Development of Recommendations. Three new items were introduced, addressing the development of a guideline protocol, support by a guideline methodologist, and consideration of surgical experience/expertise. CONCLUSION: The AGREE-S appraisal instrument has been developed to be used for assessment of the methodological and reporting quality of guidelines on surgical interventions.
BACKGROUND: The Appraisal of Guidelines Research and Evaluation (AGREE) II instrument was developed to evaluate the quality of clinical practice guidelines. Evidence suggests that development, reporting, and appraisal of guidelines on surgical interventions may be better informed by modification of the instrument. OBJECTIVE: We aimed to develop an AGREE II extension specifically designed for appraisal of guidelines of surgical interventions. METHODS: In a three-part project funded by the United European Gastroenterology and the European Association for Endoscopic Surgery, (i) we identified factors that were associated with higher quality of surgical guidelines, (ii) we statistically calibrated the AGREE II instrument in the context of surgical guidelines using correlation, reliability, and factor analysis, and (iii) we undertook a Delphi consensus process of stakeholders to inform the development of an AGREE II extension instrument for surgical interventions. RESULTS: Several features were prioritized by stakeholders as of particular importance for guidelines of surgical interventions, including development of a guideline protocol, consideration of practice variability and surgical expertise in different settings, and specification of infrastructures required to implement the recommendations. The AGREE-S-AGREE II extension instrument for surgical interventions has 25 items, compared to the 23 items of the original AGREE II instrument, organized into the following 6 domains: Scope and purpose, Stakeholders, Evidence synthesis, Development of recommendations, Editorial independence, and Implementation and update. As the original instrument, it concludes with an overall appraisal of the quality of the guideline and a judgement on whether the guideline is recommended for use. Several items were amended and rearranged among domains, and an item was deleted. The Rigor of Development domain of the original AGREE II was divided into Evidence Synthesis and Development of Recommendations. Items of the AGREE II domain Clarity of Presentation were incorporated in the new domain Development of Recommendations. Three new items were introduced, addressing the development of a guideline protocol, support by a guideline methodologist, and consideration of surgical experience/expertise. CONCLUSION: The AGREE-S appraisal instrument has been developed to be used for assessment of the methodological and reporting quality of guidelines on surgical interventions.
Authors: Melissa C Brouwers; Michelle E Kho; George P Browman; Jako S Burgers; Francoise Cluzeau; Gene Feder; Béatrice Fervers; Ian D Graham; Jeremy Grimshaw; Steven E Hanna; Peter Littlejohns; Julie Makarski; Louise Zitzelsberger Journal: J Clin Epidemiol Date: 2010-07-24 Impact factor: 6.437
Authors: Melissa C Brouwers; Michelle E Kho; George P Browman; Jako S Burgers; Francoise Cluzeau; Gene Feder; Béatrice Fervers; Ian D Graham; Jeremy Grimshaw; Steven E Hanna; Peter Littlejohns; Julie Makarski; Louise Zitzelsberger Journal: CMAJ Date: 2010-07-05 Impact factor: 8.262
Authors: Stavros A Antoniou; Sofia Tsokani; Dimitrios Mavridis; Manuel López-Cano; George A Antoniou; Dimitrios Stefanidis; Nader K Francis; Neil Smart; Filip E Muysoms; Salvador Morales-Conde; Hendrik Jaap Bonjer; Melissa C Brouwers Journal: Ann Surg Date: 2019-04 Impact factor: 12.969
Authors: Sofia Tsokani; Stavros A Antoniou; Irini Moustaki; Manuel López-Cano; George A Antoniou; Ivan D Flórez; Gianfranco Silecchia; Sheraz Markar; Dimitrios Stefanidis; Giovanni Zanninotto; Nader K Francis; George H Hanna; Salvador Morales-Conde; Hendrik Jaap Bonjer; Melissa C Brouwers; Dimitrios Mavridis Journal: Surg Endosc Date: 2021-06-22 Impact factor: 4.584
Authors: George A Antoniou; Dimitris Mavridis; Sofia Tsokani; Manuel López-Cano; Iván D Flórez; Melissa Brouwers; Sheraz R Markar; Gianfranco Silecchia; Nader K Francis; Stavros A Antoniou Journal: BMJ Open Date: 2020-08-11 Impact factor: 2.692