Evidence map›Paper›PMID 28358870›Full record

SynthesisPloS one2017

Guideline appraisal with AGREE II: Systematic review of the current evidence on how users handle the 2 overall assessments.

Wiebke Hoffmann-Eßer, Ulrich Siering, Edmund A M Neugebauer, Anne Catharina Brockhaus, Ulrike Lampert, Michaela Eikermann

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 30 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 30 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 30 syntheses or guidelines pooled it.

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  2. Quality and Consistency of Penicillin Allergy Delabelling Guidelines: A Systematic Review.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2026
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  5. A systematic evaluation of clinical practice guidelines for the treatment and management of vestibular schwannoma.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Wiebke Hoffmann-EßerInstitute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany.ORCID http://orcid.org/0000-0003-4262-3794
Ulrich SieringInstitute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany.
Edmund A M NeugebauerBrandenburg Medical School - Theodor Fontane Neuruppin, Germany & University of Witten/Herdecke, Witten/Herdecke, Germany.
Anne Catharina BrockhausInstitute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany.
Ulrike LampertInstitute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany.
Michaela EikermannMedical Advisory Service of the German Social Health Insurance (MDS), Essen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within 6 domains and 2 overall assessments (1. overall guideline quality; 2. recommendation for use). The aim of this systematic review was twofold. Firstly, to investigate how often AGREE II users conduct the 2 overall assessments. Secondly, to investigate the influence of the 6 domain scores on each of the 2 overall assessments. MATERIALS AND

methodsA systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: "yes", "yes, with modifications", "no") was examined using a multinomial regression model.

results118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development) having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 ("yes" vs. "no") and Domains 3 and 5 ("yes, with modifications" vs. "no").

conclusionsThe 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis of the individual domains could clarify their importance in terms of guideline quality. Moreover, AGREE II should require users to transparently present how they conducted the assessments.

Indexed as

LiteratureSoftwareRegression Analysis

Identifiers

PMID28358870
PMCPMC5373625

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.