title: An evaluation of cataract surgery clinical practice guidelines.
abstract: OBJECTIVE
  This study used the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument to evaluate the methodological quality of clinical practice guidelines (CPG) published by the American Academy of Ophthalmology (AAO), Canadian Ophthalmological Society (COS) and Royal College of Ophthalmologists (RCO) for the management of cataract in adults.
  
  
  METHODS
  An evaluation of the AAO, COS and RCO CPGs using a reliable and validated instrument.
  
  
  METHODS
  Four evaluators independently appraised the three CPGs using the AGREE II Instrument, which covers six domains (Scope and Purpose, Stakeholder Involvement, Rigour of Development, Clarity of Presentation, Applicability and Editorial Independence). The AGREE II includes an Overall Assessment summarising guideline methodological rigour across all domains, using a 7-point scale where perfect adherence equals a score of 7.
  
  
  RESULTS
  Scores ranged from 36% to 75% for the AAO guideline; 45% to 94% for the COS guideline and 23% to 85% for the RCO guideline. Intraclass correlation coefficients for the reliability of mean scores for the AAO, COS, and RCO were 0.78, 0.74 and 0.80; 95% CIs (0.60 to 0.90), (0.45 to 0.88) and (0.53 to 0.91), respectively. The strongest domains were Scope and Purpose (COS, RCO), Clarity of Presentation (COS, RCO) and Editorial Independence (AAO, COS). The weakest were Stakeholder Involvement (AAO), Applicability (AAO, COS) and Editorial Independence (RCO).
  
  
  CONCLUSIONS
  Cataract surgery practice guidelines can be improved by targeting stakeholder involvement, applicability and editorial independence.
authors.affiliation: Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island, USA.
authors.forename: Connie M
authors.identifier: http://orcid.org/0000-0003-0355-7851
authors.initials: CM
authors.lastname: Wu
authors.affiliation: Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island, USA.
authors.forename: Annie M
authors.identifier: http://orcid.org/0000-0001-6306-1802
authors.initials: AM
authors.lastname: Wu
authors.affiliation: Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island, USA.
authors.forename: Benjamin K
authors.initials: BK
authors.lastname: Young
authors.affiliation: Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Wu
authors.affiliation: Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Chen
authors.affiliation: Departments of Ophthalmology, Pathology and Cell Biology, Morsani College of Medicine, Tampa, Florida, USA.
authors.forename: Curtis E
authors.initials: CE
authors.lastname: Margo
authors.affiliation: Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Greenberg
mesh_terms: D002170:Canada; D002387:Cataract Extraction / Q000592:standards*; D006801:Humans; D009885:Ophthalmology / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011786:Quality Control; D011787:Quality of Health Care / Q000592:standards; D012955:Societies, Medical / Q000592:standards*; D006113:United Kingdom; D014481:United States
keywords: Lens and zonules; Medical Education; Treatment Surgery; Vision