title: A critical appraisal and comparison of the quality and recommendations of glaucoma clinical practice guidelines.
abstract: OBJECTIVE
  To appraise primary open-angle glaucoma (POAG) practice guidelines critically and to compare these guidelines' major recommendations.
  
  
  METHODS
  Evaluation of clinical practice guidelines and their development process.
  
  
  METHODS
  Glaucoma fellowship-trained ophthalmologists.
  
  
  METHODS
  The POAG clinical practice guidelines published by the American Academy of Ophthalmology (AAO), European Glaucoma Society (EGS), and South East Asia Glaucoma Interest Group (SEAGIG) were evaluated by independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.
  
  
  METHODS
  Domain scores using the AGREE instrument.
  
  
  RESULTS
  Critical appraisal using the AGREE instrument demonstrated that the AAO guidelines scored favorably (>60%) in the domains of scope and purpose, rigor of development, and clarity and presentation, while scoring unfavorably (<60%) in the domains of stakeholder involvement, applicability, and editorial independence. The Terminology and Guidelines for Glaucoma and the Asia Pacific Glaucoma Guidelines respectively developed by EGS and SEAGIG scored favorably in the domains of scope and purpose and clarity and presentation, but scored unfavorably in the domains of stakeholder involvement, applicability, and editorial independence. The major recommendations regarding diagnosis and management of POAG were similar among the 3 guidelines, although the level of detail varied considerably.
  
  
  CONCLUSIONS
  Although the clinical practice guidelines from the AAO, SEAGIG, and EGS have contributed to developing evidence-based guidelines for glaucoma management, there is variability in the quality of the guideline development process and how it is reported as evaluated by a standardized instrument. The adoption of common standards in developing clinical practice guidelines in ophthalmology should improve their consistency and quality.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Ou
authors.forename: Ivan
authors.initials: I
authors.lastname: Goldberg
authors.forename: Clive
authors.initials: C
authors.lastname: Migdal
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee
mesh_terms: D005902:Glaucoma, Open-Angle / Q000628:therapy*; D006801:Humans; D009885:Ophthalmology / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011786:Quality Control; D012955:Societies, Medical