title: Guidelines in cardiac clinical practice: evaluation of their methodological quality using the AGREE II instrument.
abstract: Although clinical guidelines have an influential role in healthcare practice, their development process and the evidence they cite has been subject to criticism. This study evaluates the quality of guidelines in cardiac clinical practice by examining how they adhere to validated methodological standards in guideline development. A structured review of cardiac clinical practice guidelines published in seven cardiovascular journals between January 2001 and May 2011 was performed. The AGREE II assessment tool was used by two researchers to evaluate guideline quality. A total of 101 guidelines were identified. Assessment of guidelines using AGREE II found methodological quality to be highly variable (median score, 58.70%; range, 45.34-76.40%). 'Scope and purpose' (median score, 86.1%) and 'clarity of development' (median score, 83.3 %) were the two domains within AGREE II that received the highest scores. Applicability (median score, 20.80%; range, 4.20-54.20%) and editorial independence (median score, 33.30%; range, 0-62.50%) had the lowest scores. There is considerable variability in the quality of cardiac clinical practice guidelines and this has not improved over the last 10 years. Incorporating validated guideline assessment tools, such as AGREE II, may improve the quality of guidelines.
authors.affiliation: Department of Surgery and Cancer, Imperial College, London W2 1NY, UK. sanjeeve.sabharwal@ic.ac.uk
authors.forename: Sanjeeve
authors.initials: S
authors.lastname: Sabharwal
authors.forename: Vanash
authors.initials: V
authors.lastname: Patel
authors.forename: Sukhjinder S
authors.initials: SS
authors.lastname: Nijjer
authors.forename: Ali
authors.initials: A
authors.lastname: Kirresh
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.forename: John C
authors.initials: JC
authors.lastname: Chambers
authors.forename: Iqbal
authors.initials: I
authors.lastname: Malik
authors.forename: Jaspal S
authors.initials: JS
authors.lastname: Kooner
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
mesh_terms: D002309:Cardiology / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D011786:Quality Control
keywords: AGREE II; cardiac practice; guidelines