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Gavriilidis P, Askari A, Gavriilidis E, et al. Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument. Ann R Coll Surg Engl. 2021;103(7):471-477doi: 10.1308/rcsann.2021.0013.
Gavriilidis, P., Askari, A., Gavriilidis, E., de'Angelis, N., Di Saverio, S., Wheeler, J., & Davies, R. J. (2021). Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument. Annals of the Royal College of Surgeons of England, 103(7), 471-477. https://doi.org/10.1308/rcsann.2021.0013
Gavriilidis, P, et al. "Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument." Annals of the Royal College of Surgeons of England vol. 103,7 (2021): 471-477. doi: https://doi.org/10.1308/rcsann.2021.0013
Gavriilidis P, Askari A, Gavriilidis E, de'Angelis N, Di Saverio S, Wheeler J, Davies RJ. Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument. Ann R Coll Surg Engl. 2021 Jul;103(7):471-477. doi: 10.1308/rcsann.2021.0013. Epub 2021 Apr 14. PMID: 33851878.
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Ann R Coll Surg Engl. 2021 Jul;103(7):471-477. doi: 10.1308/rcsann.2021.0013. Epub 2021 Apr 14.

Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument.

Annals of the Royal College of Surgeons of England

P Gavriilidis, A Askari, E Gavriilidis, N de'Angelis, S Di Saverio, J Wheeler, R J Davies

Affiliations

  1. Imperial College Healthcare NHS Trust, Hammersmith Hospital, UK.
  2. Cambridge University Hospitals NHS Foundation Trust, UK.
  3. University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
  4. University Hospital Henri Mondor (AP-HP), Créteil, France.
  5. University of Paris Est, Créteil, France.
  6. University of Insubria, Insubria, Italy.

PMID: 33851878 DOI: 10.1308/rcsann.2021.0013

Abstract

INTRODUCTION: Diverticular disease is one of the most frequent reasons for attending emergency departments and surgical causes of hospital admission. In the past decade, many surgical and gastroenterological societies have published guidelines for the management of diverticular disease. The aim of the present study was to appraise the methodological quality of these guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool.

METHODS: PubMed, Embase, Cochrane Library and Google Scholar databases were searched systematically. The methodological quality of the guidelines was appraised independently by five appraisers using the AGREE II instrument.

FINDINGS: A systematic search of the literature identified 12 guidelines. The median overall score of all guidelines was 68%. Across all guidelines, the highest score of 85% was demonstrated in the domain 'Scope and purpose'. The domains 'Clarity and presentation' and 'Editorial independence' both scored a median of 72%. The lowest scores were demonstrated in the domains 'Stakeholder involvement' and 'Applicability' at 46% and 40%, respectively. Overall, the National Institute for Health and Care Excellence (NICE) guidelines performed consistently well, scoring 100% in five of six domains; NICE was one of the few guidelines that specifically reported stakeholder involvement, scoring 97%. Generally, the domain of 'Stakeholder involvement' ranked poorly with seven of twelve guidelines scoring below 50%, with the worst score in this domain demonstrated by Danish guidelines at 25%.

CONCLUSION: Six of twelve guidelines (NICE, American Society of Colon & Rectal Surgeons (ASCRS), European Society of Coloproctology (ESCP), American Gastroenterological Association, German Society of Gastroenterology/German Society for General and Visceral Surgery (German), Netherlands Society of Surgery) scored above 70%. Only three, NICE, ASCRS and ESCP, scored above 75% and were voted unanimously by the appraisers for use as they are. Therefore, use of AGREE II may help improve the methodological quality of guidelines and their future updates.

Keywords: Appraisal of Guidelines Research and Evaluation II; Clinical practice guidelines; Diverticular disease; Diverticulitis

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