AGREE II Domain |
Strengths |
Limitations |
Domain 1. Scope and Purpose
|
Objectives, purpose, health intent, clinical questions, patient
population were clearly mentioned in the CPG full document or the
website using the PICO model (NICE, NHLBI, RCOG).
|
Target users were general rather than specific (ACOG)
|
Domain 2. Stakeholder Involvement
|
GDG members’ names, specialties, institutions, and geographical
locations were clearly mentioned and easy to find. GDG included
methodologist(s) (NICE, RCOG).
GDG included members from relevant professional groups including
patient representatives (NICE)
|
GDG disciplines and roles were not clearly mentioned (ACOG).
GDG was missing some key disciplines (e.g. pharmacists and nurses)
(RCOG)002E
Lack of adequate and clear descriptions of patient participation or
preferences and target users (ACOG, NHLBI).
|
Domain 3. Rigour of development
|
Detailed evidence search keywords were mentioned (NICE, RCOG).
The GRADE (Grading of Recommendations Assessment, Development and
Evaluation) approach to assess the quality of evidence was utilized
(NICE, NHLBI)
Recommendations include health benefits, harms, and side effects of
recommendations with or without a discussion of their trade-offs
(NICE, NHLBI).
All recommendations were linked to their relevant primary source of
evidence (NICE, NHLBI, RCOG).
Lists and processes of external review were clearly reported and easy
to find (NICE, NHLBI, RCOG).
Updating was clearly mentioned (NICE, RCOG).
|
Lack of detailed search strategy (ACOG).
Strengths and limitations of the body of evidence (evidence tables)
were not clearly reported (ACOG).
Lack of detailed process for formulation of the recommendations, and
discussion of trade-off between harms and benefits (ACOG, RCOG).
Details and methods of the external review process and outcomes were
not clearly reported (ACOG).
Review and update process was not reported (ACOG, NHLBI)
|
Domain 4. Clarity and presentation
|
This domain was well-addressed in most included CPGs, where key
recommendations were specific, unambiguous, and easily identifiable in
all CPGs (NICE, NHLBI, RCOG).
|
Management of SCD Crisis in different pregnancy trimesters and
abnormal fetal surveillance management were not highlighted (ACOG).
|
Domain 5. Applicability
|
Some facilitators and barriers to implementations and clinical
governance issues were discussed (NHLBI, NICE, RCOG).
A package of CPG Implementation tools were provided like educational
tools (NICE), protocols (NHLBI), summary document (NHLBI, NICE, RCOG),
patient information (NHLBI, NICE), clinical algorithm or pathway
(NHLBI, NICE), baseline assessment sheet (NICE), Mobile App (RCOG).
Quality standards, measures, indicators, and/ or clinical audit
criteria were provided (NICE, RCOG).
A formal economic analysis was conducted (NICE).
|
Facilitators and barriers to implementations were not explicitly
mentioned (ACOG).
Implementation tools were not provided (ACOG).
Quality measures or key performance indicators were not provided
(ACOG, NHLBI).
No formal economic analysis was conducted (ACOG, NHLBI, and RCOG).
|
Domain 6. Editorial independence
|
Funding with or without an influence statement were mentioned (NICE,
NHLBI, RCOG).
DCOI statements were clearly provided (NICE, NHLBI, RCOG).
|
Funding and influence statements were not clearly reported (ACOG,
NHLBI).
No DCOI statements were provided (ACOG).
|