A critical appraisal of clinical practice guidelines for the treatment of lower-limb osteoarthritis

Table 3 Ratings^a according to the AGREE instrument of osteoarthritis treatment guidelines published within the past 5 years

		Rating of guidelines [reference]
AGREE instrument used for rating
		Canadian Consensus	North of	ADMMC OA
Domain	Item	Conference[11]	England [12,13]	[14,15,16]	ICSI [17,18]	EULAR [6]	ACR [4,5]
Scope and purpose
	1. Overall objective(s)	+	+	+	+	+	+
	2. Clinical question(s)	+	+	+	+	+	-^b
	3. Target patient population	+	+	+	+	+	+
Stakeholder involvement
	4. Development group representative	+^b	+	+	+	-	-
	5. Patient views and preferences	+	-	-^b	-	-	+
Rigour of development
	6. Systematic evidence search	-	+	-^b	-	+	-
	7. Selection of evidence explicit	-	+	-	-	+	-
	8. Formulation of recommendations explicit	-	+	+	-	+	-
	9. Benefits, side effects, and risks described	+	+	+	+^b	+	+
	10. Explicit link between evidence and recommendations	+^b	+	+	+	+	+
	11. External review	+	+	+	-^b	-	-
	12. Procedure for updating guideline	+	+	-	+	+	+
Clarity and presentation
	13. Specific and unambiguous recommendations	+	+	+	+	+	+^b
	14. Different treatment options	+	+	+	+	+	+
	15. Key recommendations easily identified	-^b	+	+	+^b	+	+^b
Applicability
	16. End users of guideline stated	+	+	+	+	-^b	-
	17. Barriers to implementation are discussed	-	-	-^b	+	-	-
	18. Cost implications are discussed	-	+	-	-	-	+
	19. Tools for application	-	-	-^b	+	-	-
	20. Review/monitoring criteria defined	-	-	-	+	-	-
	21. Pilot testing	-	-	+	+	-	+
Editorial independence
	22. Editorial independent from funding body	-	-	-	-	-	-
	23. Conflicts of interest are stated	-	+	-	-	-	+

^aRatings on a 4-point scale (4 = strongly agree, 1 = strongly disagree) have been dichotomized for purposes of clarity (see text): + indicates that the guideline has met the criterion; – indicates that it has not. ^bOne of the raters disagreed (see text). ADMMC = Algorithms for the Diagnosis and Management of Musculoskeletal Complaints; ACR = American College of Rheumatology; EULAR = European League Against Rheumatism; ICSI = Institute for Clinical Systems Improvement.

ISSN: 1478-6362