engleski

Quality of evidence-based practice guidelines published in Croatia, 2004-2014: evaluation using the AGREE II tool

Background and objective: We assessed the quality of guidelines published between 2004 and 2014 by the Croatian Medical Association. Methods: Four independent raters assessed 51 guidelines from various clinical fields by using the validated AGREE II tool. The total score and the domain scores of AGREE scale were expressed as the percentage of maximum score. Results: The raters scored consistently on AGREE II scale (average per- study interclass correlation coefficient = 0.82 ; range 0.60- 0.91). Generally, the score was low, with the median total AGREE score of 35% (interquartile range, 29-43%). The domain “Rigour of Development”, which assesses the evidence-based quality of recommendations, was among the worst rated (23%, interquartile range 16-34%). We did not observe any time-trend on domain scores, except for the increasing trend for the “Stakeholder Involvement” domain scores (trend- analysis, P=0.038). The composition of official bodies/type of developers constituting a guideline’s working group clearly affected the end-quality of a guideline. National level guidelines supported by the Ministry of Health and unofficial working groups, regardless of the support from official professional societies, were the guidelines that constantly achieved highest scores throughout AGREE II domains. Moreover, the quality of guideline weakly decreased by the inclusion of greater number of official clinical societies in their development (Kendall’s tau correlation from -0.229 to -0.278, P≤0.046 on two out of six AGREE domains and on the total score). Conclusion: Guideline developers in Croatia should adopt better methodological framework in order to improve the quality of their clinical practice guidelines.

practice guidelines ; quality assessment ; AGREE-II ; Croatia

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