title: An exploratory quality assessment of orthodontic clinical guidelines using the AGREE II instrument.
abstract: OBJECTIVE
  Clinical guidelines act as a means of assisting clinicians in improving the quality of healthcare provided. We aim to assess the quality of currently available international orthodontic guidelines.
  
  
  METHODS
  A cross-sectional systematic assessment of orthodontic clinical guidelines was undertaken. A Medline search using the keywords 'guideline', 'orthodontics', and 'dent', and search of specific dental and orthodontic organization websites for orthodontic-related clinical guidelines. Relevant guidelines published between 1999 and 2012 in English were identified. Draft guidelines and endorsements were excluded. The quality of each guideline was evaluated by a single calibrated assessor using the AGREE II instrument. Variation in the quality of guidelines produced by different organizations was also assessed.
  
  
  RESULTS
  Seventeen guidelines were included in this study. Overall, the reporting of scope and purpose (84.31, 95% CI: 70.91-97.72) and clarity of presentation (75.49, 95% CI: 61.68-89.3) domains of the AGREE II instrument were deemed of high quality. Lower scores were obtained for the following domains: rigour of development (52.08, 95% CI: 37.59-66.57), editorial independence (47.06, 95% CI: 20.6-73.51), stakeholder agreement (46.41, 95% CI: 29.66-63.15), and applicability (27.45, 95% CI: 8.26-46.64). There was a noted difference in the individual domain scores of orthodontic guidelines produced by the different organizations.
  
  
  CONCLUSIONS
  In relation to the AGREE II instrument, the quality of orthodontic guidelines for use in clinical practice are deemed sub-optimal. Variation in the quality of guidelines produced different organizations is evident.
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, Kings College Hospital NHS Foundation Trust, London, UK.
authors.forename: Tasneem
authors.initials: T
authors.lastname: Tejani
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, Floor 22, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors.forename: Suhaym
authors.initials: S
authors.lastname: Mubeen
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, Floor 22, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors.forename: Jadbinder
authors.initials: J
authors.lastname: Seehra
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, Floor 22, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors.forename: Martyn T
authors.initials: MT
authors.lastname: Cobourne
mesh_terms: D003430:Cross-Sectional Studies; D055094:Evidence-Based Dentistry / Q000592:standards; D006801:Humans; D009970:Orthodontics / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D011787:Quality of Health Care