title: Inconsistencies in clinical guidelines for obstetric anaesthesia for Caesarean section: a comparison of the Danish, English, American, and German guidelines with regard to developmental quality and guideline content.
abstract: BACKGROUND
  Anaesthetists need evidence-based clinical guidelines, also in obstetric anaesthesia. We compared the Danish, English, American, and German national guidelines for anaesthesia for Caesarean section. We focused on assessing the quality of guideline development and evaluation of the guidelines' content.
  
  
  METHODS
  We compared the four countries' guideline developmental quality by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument, an international tool for development and assessment of guidelines. The clinically important content of these countries' guidelines was compared.
  
  
  RESULTS
  We found differences in the quality of guideline development in the four countries. The German guidelines scored very low in the AGREE analysis, and the Danish national guideline scored low in the AGREE analysis. The American and British guideline both achieved high scores in the AGREE analysis. We found differences in the content of the four countries' guidelines. The Danish, American, and British guidelines were comprehensive but with some variation in the content.
  
  
  CONCLUSIONS
  Development of national guidelines might benefit from following standardised regulations, such as those used in the AGREE tool. Content of guidelines is not standardised. Recommendations for the content of guidelines might contribute to standardising clinical guidelines.
authors.affiliation: Department of Anaesthesiology, Lillebaelt Hospital, Kolding, Denmark. louisejoergen@yahoo.dk
authors.forename: L P
authors.initials: LP
authors.lastname: Winther
authors.forename: A U
authors.initials: AU
authors.lastname: Mitchell
authors.forename: A M
authors.initials: AM
authors.lastname: Møller
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000592:standards*; D002585:Cesarean Section / Q000592:standards*; D003718:Denmark; D005260:Female; D005858:Germany; D017408:Guidelines as Topic / Q000592:standards*; D006801:Humans; D007802:Language; D011247:Pregnancy; D011787:Quality of Health Care; D006113:United Kingdom; D014481:United States