title: Methodological rigor and reporting of clinical practice guidelines in patients with allergic rhinitis: QuGAR study.
abstract: BACKGROUND
  There are several clinical practice guidelines about the management of allergic rhinitis (AR) being used by clinicians.
  
  
  OBJECTIVE
  We sought to assess the methodological rigor and transparency of reporting of clinical practice guidelines for the management of AR.
  
  
  METHODS
  We systematically searched MEDLINE, the TRIP database, and professional society Web sites for all guidelines about the management of AR published in English after the year 2000. Four reviewers independently assessed the rigor of development and reporting of included guidelines using the Appraisal of Guidelines for Research and Evaluation II instrument.
  
  
  RESULTS
  Our search revealed 432 records, of which 34 full-text articles were assessed for eligibility and 10 fulfilled inclusion criteria. Overall methodological rigor and reporting of guidelines varied from fulfilling most of the Appraisal of Guidelines for Research and Evaluation II criteria to almost none. Across all guidelines, the best reported domain was clarity of presentation, and the least rigorously addressed domain was applicability of guidelines. Agreement beyond chance among the 4 appraisers was fair.
  
  
  CONCLUSIONS
  Guideline users should be aware of the difference in the rigor of development and quality of reporting of guidelines about the management of AR. They should choose higher-quality guidelines to use in their practice and teaching. For most reviewed guidelines, there is room for improvement, particularly in the domains of applicability and implementation.
authors.affiliation: Department of Medicine, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Padjas
authors.affiliation: Undergraduate Medical Education Program, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Rohan
authors.initials: R
authors.lastname: Kehar
authors.affiliation: Dartmouth Hitchcock Medical Center, Lebanon, NH.
authors.forename: Sohaib
authors.initials: S
authors.lastname: Aleem
authors.affiliation: Department of Medicine, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Filip
authors.initials: F
authors.lastname: Mejza
authors.affiliation: Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve and INSERM CESP U1018, Montpellier, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Bousquet
authors.affiliation: Departments of Clinical Epidemiology & Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Holger J
authors.initials: HJ
authors.lastname: Schünemann
authors.affiliation: Departments of Clinical Epidemiology & Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada. Electronic address: brozekj@mcmaster.ca.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Brożek
mesh_terms: D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000628:therapy*
keywords: Allergic rhinitis; Appraisal of Guidelines for Research and Evaluation instrument; guidelines; methodology