title: The methodological quality of clinical guidelines of the European Society of Human Reproduction and Embryology (ESHRE).
abstract: BACKGROUND
  Clinical practice guidelines bridge the gap between the evidence from literature and clinical practice, and they may provide guidance in ethical, legal and societal dilemmas. To explore the potentials for future international guideline development within the field of human reproduction and embryology, we assessed the quality of existing guidelines produced by the European Society of Human Reproduction and Embryology (ESHRE).
  
  
  METHODS
  We systematically searched for the ESHRE guidelines produced after 1996 in electronic databases and on the Internet. Subsequently, we assessed the methodological quality of these guidelines using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument.
  
  
  RESULTS
  The overall methodological quality of most of the 11 selected ESHRE guidelines was poor. Most of the guidelines scored <30% in the domains of 'stakeholder involvement', 'rigour of development', 'applicability' and 'editorial independence'. Only one guideline was rated 'strongly recommended'.
  
  
  CONCLUSIONS
  The methodological quality of the guidelines produced under the auspices of ESHRE can be improved. We suggest a systematic, up-to-date methodology, investment in guideline development specialists, systematic quality control and the incorporation of indicator development. Furthermore, attention should be paid to the document nomenclature, and an ESHRE guidelines' summary on a special part of the ESHRE website would be a good initiative.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. w.nelen@obgyn.umcn.nl
authors.forename: W L D M
authors.initials: WL
authors.lastname: Nelen
authors.forename: R W
authors.initials: RW
authors.lastname: van der Pluijm
authors.forename: R P M G
authors.initials: RP
authors.lastname: Hermens
authors.forename: C
authors.initials: C
authors.lastname: Bergh
authors.forename: P
authors.initials: P
authors.lastname: de Sutter
authors.forename: K G
authors.initials: KG
authors.lastname: Nygren
authors.forename: A M M
authors.initials: AM
authors.lastname: Wetzels
authors.forename: R P T M
authors.initials: RP
authors.lastname: Grol
authors.forename: J A M
authors.initials: JA
authors.lastname: Kremer
mesh_terms: D005060:Europe; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D015397:Program Evaluation / Q000592:standards; D019984:Quality Indicators, Health Care; D018456:Reproductive Medicine / Q000592:standards*; D012955:Societies, Medical