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An evaluation of cataract surgery clinical practice guidelines
  1. Connie M Wu1,2,3,
  2. Annie M Wu1,2,3,
  3. Benjamin K Young1,2,3,
  4. Dominic Wu1,2,3,
  5. Allison Chen1,2,3,
  6. Curtis E Margo4,
  7. Paul B Greenberg1,2,3
  1. 1Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA
  2. 2Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
  3. 3Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island, USA
  4. 4Departments of Ophthalmology, Pathology and Cell Biology, Morsani College of Medicine, Tampa, Florida, USA
  1. Correspondence to Dr Paul B Greenberg, Section of Ophthalmology, Providence VA Medical Center, 830 Chalkstone Ave, Providence, Rhode Island 02908, USA; paul_greenberg{at}brown.edu

Abstract

Purpose This study used the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument to evaluate the methodological quality of clinical practice guidelines (CPG) published by the American Academy of Ophthalmology (AAO), Canadian Ophthalmological Society (COS) and Royal College of Ophthalmologists (RCO) for the management of cataract in adults.

Study design An evaluation of the AAO, COS and RCO CPGs using a reliable and validated instrument.

Methods Four evaluators independently appraised the three CPGs using the AGREE II Instrument, which covers six domains (Scope and Purpose, Stakeholder Involvement, Rigour of Development, Clarity of Presentation, Applicability and Editorial Independence). The AGREE II includes an Overall Assessment summarising guideline methodological rigour across all domains, using a 7-point scale where perfect adherence equals a score of 7.

Results Scores ranged from 36% to 75% for the AAO guideline; 45% to 94% for the COS guideline and 23% to 85% for the RCO guideline. Intraclass correlation coefficients for the reliability of mean scores for the AAO, COS, and RCO were 0.78, 0.74 and 0.80; 95% CIs (0.60 to 0.90), (0.45 to 0.88) and (0.53 to 0.91), respectively. The strongest domains were Scope and Purpose (COS, RCO), Clarity of Presentation (COS, RCO) and Editorial Independence (AAO, COS). The weakest were Stakeholder Involvement (AAO), Applicability (AAO, COS) and Editorial Independence (RCO).

Conclusions Cataract surgery practice guidelines can be improved by targeting stakeholder involvement, applicability and editorial independence.

  • Lens and zonules
  • Treatment Surgery
  • Vision
  • Medical Education

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