title: The quality of European dermatological guidelines: critical appraisal of the quality of EDF guidelines using the AGREE II instrument.
abstract: Clinical practice guidelines are systematically developed tools to assist clinicians and health policy makers in decision making for clearly defined clinical situations. In the light of the demand for evidence-based medicine and quality in health care and the increasing methodological requirements concerning guidelines development, it is important to evaluate existing practice guidelines to systematically identify strengths and weaknesses. Currently, the most accepted tool for the methodological evaluation of guidelines is the Appraisal of Guidelines for Research & Evaluation (AGREE) Instrument. Intention of this assessment is to identify and critically appraise clinical practice guidelines commissioned by the European Dermatology Forum (EDF). A quality assessment of a predefined set of guidelines, including all available clinical practice guidelines published on the EDF guidelines internet site, was performed using the AGREE II instrument. To assure an objective assessment, four independent assessments were performed by evaluators situated in different European countries. Twenty-five EDF guidelines covering different dermatological topics were identified and evaluated. The assessment included seven guidelines developed on the highest methodological standard (systematic literature search and structured consensus conference, S3). Eighteen guidelines were identified that were based on either a structured consensus process (S2k), a systematic literature assessment (S2e) or on informal consensus only (S1). The methodological and reporting quality among the evaluated guidelines was heterogeneous. S3 guidelines generally received the highest scores. The domains 'clarity of presentation' and 'scope and purpose' achieved the highest mean ratings within the different domains of assessment, whereas the domains of 'applicability', 'stakeholder involvement' and 'editorial independence' scored poorly. Considering the large variations in the achieved scores, there is need for methodological harmonization within the EDF guidelines to achieve comparable methodological standards.
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: R N
authors.initials: RN
authors.lastname: Werner
authors.affiliation: Department of Dermatology and Venereology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: B
authors.initials: B
authors.lastname: Marinović
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Rosumeck
authors.affiliation: Department of Dermatology and Venereology, Federal Academic Teaching Hospital, Feldkirch, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Strohal
authors.affiliation: Department of Dermatology and Venereology, Federal Academic Teaching Hospital, Feldkirch, Austria.
authors.forename: N S
authors.initials: NS
authors.lastname: Haering
authors.affiliation: Evidence-Based Medicine Frankfurt, Institute for General Practice, Goethe University, Frankfurt, Germany.|Department of Dermatology, J.W. Goethe-University Hospital, Frankfurt, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Weberschock
authors.affiliation: Evidence-Based Medicine Frankfurt, Institute for General Practice, Goethe University, Frankfurt, Germany.
authors.forename: A C
authors.initials: AC
authors.lastname: Dreher
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Nast
mesh_terms: D032921:Consensus; D003880:Dermatology / Q000592:standards*; D005060:Europe; D006801:Humans; D017410:Practice Guidelines as Topic; D012871:Skin Diseases / Q000628:therapy*