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| AGREE II domain | Strengths | Weaknesses |
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| (1) Scope and Purpose | Objectives clearly stated; specific health questions clearly described
Patient population clearly specified (AAO) | None identified |
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| (2) Stakeholder Involvement | CPG development group members’ names, disciplines, institutions, and geographic locations clearly listed and easy to locate (RCO)
Guideline development group included individuals from relevant professional groups, including a patient representative (RCO) | No statement of type of strategy used to capture views and preferences of the patients/public
Lack of outcomes gathered from patients/public and how feedback was used in guideline development process |
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| (3) Rigor of Development | Recommendations describing health benefits, risks, and side effects of recommendations
Recommendations preceded by a section detailing pertinent evidence
A primary source (AAO) cited by each recommendation
Guideline externally reviewed prior to publication; next review date provided | Lack of search terms for evidence, full search strategy, time periods searched, name of databases, and/or inclusion/exclusion criteria
Lack of rating system for quality of evidence; recommendations lacking direct citation of evidence (RCO)
No clear description of recommendation formulation process (e.g., voting procedures)
Methods/outcomes of external review not explicit |
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| (4) Clarity of Presentation | Specific and unambiguous wording of recommendations
Different options for treatment clearly presented in tables (AAO) | Key recommendations difficult to identify, particularly when embedded in main body of text or given without direct evidence citation |
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| (5) Applicability | Tools and advice provided for recommendation implementation: list of major recommendations, treatment trial summaries, glossary, and links to patient education materials (AAO)
Auditing criteria (e.g., recommended medication dosages and follow-up intervals) listed in tables (AAO) | Lack of descriptions of facilitators and barriers to application (AAO)
Lack of a clear summary document of key recommendations (RCO)
Resource implications not addressed: no mention of health economist as part of guideline development group, no information on types of cost data considered, and/or methods by which data was sought |
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| (6) Editorial Independence | Independence of funding body clearly stated (AAO)
Conflicts of Interest (COIs) disclosed for all group members (AAO) | Independence of funding body not clearly stated (RCO)
COIs for group members other than the chair not listed (RCO)
Lack of methods by which potential COIs were sought and description of how competing interests influenced the guideline development process |
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