title: An appraisal of clinical practice guidelines for constipation: a right attitude towards to guidelines.
abstract: BACKGROUND
  Clinical practice guidelines (CPGs) are formally developed statements that assist users to provide proper health care for a kind of disease and play a significant contribution in healthcare system. This study report the methodological quality of CPGs on constipation.
  
  
  METHODS
  The "Appraisal of Guidelines and Research and Evaluation" (AGREEII) instrument was developed to determine the quality of CPGs. A comprehensive search was developed using five databases and three guideline websites until/up to December, 2015. Four independent authors evaluated the methodological issues of the CPGs by the AGREEII instrument.
  
  
  RESULTS
  We identified 22 relevant guidelines on constipation from 1234 citations. The overall agreement among evaluators was 0.84 using the intra-class correlation coefficient. The mean AGREEII scores for the domains "scope and purpose" (51.77) and "rigor of development" (56.73) were moderate; afterward, three domains "stakeholder involvement" (32.23), "editorial independence" (29.59) and "applicability" (29.14) were low scores. The "clarity and presentation" (23.73) had the lowest scores.
  
  
  CONCLUSIONS
  Although existing constipation guidelines may accurately reflect current clinical practices, many guidelines' methodological quality is low. Therefore, more emphasis and attentions should be taken to the development of high-quality guidelines.
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Tian
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ding
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China. gongjianfeng@aliyun.com.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Gong
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Ge
authors.affiliation: Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA.
authors.forename: Lynne V
authors.initials: LV
authors.lastname: McFarland
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Qiyi
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Chunlian
authors.initials: C
authors.lastname: Ma
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Weiming
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China. liningrigsnju@163.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D003248:Constipation / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*
keywords: AGREEII; Clinical practice guideline; Constipation