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2. AGREE-S: AGREE II extension for surgical interventions – United European Gastroenterology and European Association for Endoscopic Surgery methodological guide

Author

Logullo, P, Florez, ID, Antoniou, GA, Markar, S, López‐Cano, M, Silecchia, G, Tsokani, S, Mavridis, D, Brouwers, M, Antoniou, SA, Sami Abdel Dayem Amer, Y, Bertolaccini, L, Alonso‐Coello, P, Akl, EA, Chand, M, Como, JJ, Borst, GJ, Di Saverio, S, Emile, S, Eom, BW, Gorter, R, Hanna, G, Immonen, K, Lai, Q, Lumen, N, Mathew, JL, Montendori, A, Moya, M, Pellino, G, Sanabria, A, Saratzis, A, Smart, N, Stefanidis, D, Zaninotto, G, Paediatric Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Reproduction & Development (AR&D), Pediatric surgery, Patricia, Logullo, Ivan D, Florez, George A, Antoniou, Sheraz, Markar, Manuel, López-Cano, Gianfranco, Silecchia, Sofia, Tsokani, Dimitrios, Mavridi, Melissa, Brouwer, Stavros A, Antoniou, Sami Abdel Dayem Amer, Yasser, Bertolaccini, Luca, Alonso-Coello, Pablo, A Akl, Elie, Chand, Manish, J Como, John, J de Borst, Gert, Di Saverio, Salomone, Emile, Sameh, Wool Eom, Bang, Gorter, Ramon, Hanna, George, Immonen, Kaisa, Lai, Quirino, Lumen, Nicolaa, L Mathew, Joseph, Montendori, Alessandro, Moya, Martin, Pellino, Gianluca, Sanabria, Alvaro, Saratzis, Athanasio, Smart, Neil, Stefanidis, Dimitrio, Zaninotto, Giovanni, Institut Català de la Salut, [Logullo P] Department Nuffield of Orthopaedics, Rheumatology & Musculoskeletal Sciences, UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, UK. [Florez ID] Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. Department of Pediatrics, University of Antioquia, Medellin, Colombia. [Antoniou GA] Department of Vascular and Endovascular Surgery, Manchester University NHS Foundation Trust, Manchester, UK. Division of Cardiovascular Sciences, School of Medical Sciences, The University of Manchester, Manchester, UK. [Markar S] Nuffield Department of Surgery, University of Oxford, Oxford, Oxfordshire, UK. Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden. [López-Cano M] Unitat de Cirurgia de la Paret Abdominal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Silecchia G] Department of Medico‐Surgical Sciences and Translation Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Surgical Procedures, Operative [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], evidence, gastroenterology, factor analysis, methodology, intervenciones quirúrgicas [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], agree ii, agree-s, guidelines, quality, endoscopy, factor analysis, statistical, humans, Oncology, Operacions quirúrgiques, Factor Analysis, Statistical, Gastroenterologia, Health Occupations::Medicine::Internal Medicine::Gastroenterology [DISCIPLINES AND OCCUPATIONS], guideline, statistical, profesiones sanitarias::medicina::medicina interna::gastroenterología [DISCIPLINAS Y OCUPACIONES], Human
Abstract

Evidence; Guidelines; Quality Evidencia; Pautas; Calidad Evidència; Pautes; Qualitat Background The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument has been developed to inform the methodology, reporting and appraisal of clinical practice guidelines. Evidence suggests that the quality of surgical guidelines can be improved, and the structure and content of AGREE II can be modified to help enhance the quality of guidelines of surgical interventions. Objective To develop an extension of AGREE II specifically designed for guidelines of surgical interventions. Methods In the tripartite Guideline Assessment Project (GAP) funded by United European Gastroenterology and the European Association for Endoscopic Surgery, (i) we assessed the quality of surgical guidelines and we identified factors associated with higher quality (GAP I); (ii) we applied correlation analysis, factor analysis and the item response theory to inform an adaption of AGREE II for the purposes of surgical guidelines (GAP II); and (iii) we developed an AGREE II extension for surgical interventions, informed by the results of GAP I, GAP II, and a Delphi process of stakeholders, including representation from interventional and surgical disciplines; the Guideline International Network (GIN); the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group; the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) initiative; and representation of surgical journal editors and patient/public. Results We developed AGREE-S, an AGREE II extension for surgical interventions, which comprises 24 items organized in 6 domains; Scope and purpose, Stakeholders, Evidence synthesis, Development of recommendations, Editorial independence, and Implementation and update. The panel of stakeholders proposed 3 additional items: development of a guideline protocol, consideration of practice variability and surgical/interventional expertise in different settings, and specification of infrastructures required to implement the recommendations. Three of the existing items were amended, 7 items were rearranged among the domains, and one item was removed. The domain Rigour of Development was divided into domains on Evidence Synthesis and Development of Recommendations. The new domain Development of Recommendations incorporates items from the original AGREE II domain Clarity of Presentation. Conclusion AGREE-S is an evidence-based and stakeholder-informed extension of the AGREE II instrument, that can be used as a guide for the development and adaption of guidelines on surgical interventions. The Guideline Assessment Project (GAP) III received financial support from the United European Gastroenterology (UEG) and the European Association for Endoscopic Surgery and Other Interventional Techniques (EAES), both non-profit organizations. The funders had no role in the design or development of this project.

Published
2022
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