A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett's Esophagus Using the AGREE II Tool

Denisse C Dayto; Andrew Sephien; Tea Reljic; Farina Klocksieben; Samuel Slone; Ambuj Kumar; Wojciech Blonski

doi:10.1097/MCG.0000000000002121

A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett's Esophagus Using the AGREE II Tool

J Clin Gastroenterol. 2024 Dec 30. doi: 10.1097/MCG.0000000000002121. Online ahead of print.

Authors

Denisse C Dayto¹, Andrew Sephien², Tea Reljic³, Farina Klocksieben³, Samuel Slone⁴, Ambuj Kumar^{3

5}, Wojciech Blonski^{4

6}

Affiliations

¹ Division of Liver Disease and Transplant Hepatology, Department of Medicine, Rutgers Health New Jersey Medical School-University Hospital, Newark, NJ.
² Division of Cardiovascular Disease, University of Miami/Jackson Memorial Hospital, Miami.
³ Research Methodology and Biostatistics Core, Office of Research, University of South Florida.
⁴ Division of Digestive Diseases and Nutrition, Department of Internal Medicine, University of South Florida Health.
⁵ Department of Internal Medicine, Morsani College of Medicine, University of South Florida.
⁶ Division of Gastroenterology, James A Haley Veterans' Hospital, Tampa, FL.

PMID: 39761162
DOI: 10.1097/MCG.0000000000002121

Abstract

Background: Several clinical practice guidelines (CPGs) exist for managing Barrett's esophagus (BE). However, the methodological quality of these CPGs is not known. To summarize the methodological quality of CPGs, we performed a critical appraisal of all available CPGs for the management of BE published from January 2018 to February 2023.

Methods: A comprehensive search of EMBASE and PubMed was conducted to identify eligible CPGs published from January 1, 2018, until February 24, 2023, addressing the management of BE. The Canadian Agency for Drugs and Technologies broad filter was also utilized in the search. The quality of the CPGs was independently assessed and evaluated by 2 reviewers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, with domain scores showing good quality being >80% and sufficient quality being >60%. The search yielded 652 citations, of which 5 CPGs met eligibility.

Results: Three CPGs were published by gastroenterology societies in the United States and 2 in Europe. The overall median score for the AGREE II domain was 100% for scope and purpose, 93% for stakeholder involvement, 93% for rigor of development, 93% for clarity of presentation, 75% for applicability, and 75% for editorial independence.

Conclusion: The findings from our study show that there is significant variability in the methodological quality of the CPGs for the management of BE across different domains. The application of the AGREE II tool can help CPG developers in improving the methodological rigor and applicability of CPGs.