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Connie Wu, Annie Wu, Benjamin Young, Dominic J Wu, Curtis Margo, Paul B Greenberg; An appraisal of clinical practice guidelines for diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):140.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the methodological quality of clinical practice guidelines (CPGs) published by the American Academy of Ophthalmology (AAO), Canadian Ophthalmological Society (COS), and Royal College of Ophthalmologists (RCO) for the management of diabetic retinopathy in adults.
Four evaluators independently appraised the three CPGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument, which covers six domains (Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability, and Editorial Independence). This includes an Overall Assessment summarizing guideline methodological rigor across all domains, using a seven-point scale where perfect adherence equals a score of seven.
Scores ranged from 35% to 78% for the AAO guideline; 60% to 92% for the COS guideline; and 35% to 82% for the RCO guideline. Intraclass correlation coefficients for the reliability of mean scores for the AAO, COS, and RCO were 0.78, 0.78, and 0.79; 95% CIs [0.60-0.89], [0.56-0.90], and [0.56-0.91], respectively. The strongest domains were Scope and Purpose and Clarity of Presentation (COS). The weakest were Stakeholder Involvement (AAO), Rigor of Development (AAO, RCO), Applicability, and Editorial Independence (RCO).
Diabetic retinopathy practice guidelines can be improved by targeting stakeholder involvement, rigor of development, applicability, and editorial independence.
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