Limitations concerning evaluation of the current guidelines using the Appraisal of Guidelines Research and Evaluation II
Letter to the Editor

Limitations concerning evaluation of the current guidelines using the Appraisal of Guidelines Research and Evaluation II

Paschalis Gavriilidis1^, Alan Askari2^, Efstratios Gavriilidis3^, Salomone Di Saverio4^, R. Justin Davies5,6^, Nicola de’Angelis7^

1Department of Surgery, University Hospitals of Coventry and Warwickshire NHS, Coventry, UK; 2Cambridge Oesophagogastric Centre, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; 3First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece; 4Department of Surgery, University of Insubria, Insubria, Italy; 5Cambridge Colorectal Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; 6School of Medicine, University of Cambridge, Cambridge, UK; 7Department of Digestive Surgery, University Hospital Henri Mondor (AP-HP), Créteil and University of Paris Est, Créteil, France

^ORCID: Paschalis Gavriilidis, 0000-0001-7773-2291; Alan Askari, 0000-0001-5993-7613; Efstratios Gavriilidis, 0000-0002-1591-9760; Salomone Di Saverio, 0000-0001-5685-5022; R. Justin Davies, 0000-0001-6904-1255; Nicola de’Angelis, 0000-0002-1211-4916.

Correspondence to: Paschalis Gavriilidis, MD, Msc, PhD. Department of Surgery, University Hospitals of Coventry and Warwickshire NHS, Coventry, UK; Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK. Email: pgavrielidis@yahoo.com.

Response to: Jongen J, Petersen S, Kleijnen J. Guideline on haemorrhoids: AGREE-II-Criteria can be applied in different ways? Ann Transl Med 2023;11:373.

Submitted May 12, 2023. Accepted for publication Jun 06, 2023. Published online Jun 26, 2023.

doi: 10.21037/atm-2023-10

We would like to thank our colleagues for their interest in our work (1). They rightly mentioned that there is a discrepancy in the evaluation of guidelines in recently published paper (2). However, this topic is discussed in detail in our manuscript and we make particular reference to this in the discussion (3). In particular, we outline to the readership that some of the limitations are inherent to the limitations of the Appraisal of Guidelines Research and Evaluation II (AGREE II) checklist itself. We draw special attention to the AGREE II tool giving equal weight to all of its domains, implying that they are all equally as important as each other in formulating an overall impression of a guideline. However, this may not necessarily be the case. Furthermore, we underlined that although the assessors were blinded to one another’s answers, loyalty to home/regional societies or familiarity with certain guidelines could have swayed an assessor’s score. Moreover, these limitations have been mentioned in our previous publications appraising guidelines for other clinical conditions (4-6).

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office Annals of Translational Medicine. The article did not undergo external peer review.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-2023-10/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

  1. Jongen J, Petersen S, Kleijnen J. Guideline on haemorrhoids: AGREE-II-Criteria can be applied in different ways? Ann Transl Med 2023;11:375.
  2. Gavriilidis P, Askari A, Gavriilidis E, et al. Evaluation of the current guidelines for the management of haemorrhoidal disease using the Appraisal of Guidelines Research and Evaluation II instrument. Ann Transl Med 2023;11:265. [Crossref] [PubMed]
  3. Gavriilidis P, Askari A, Gavriilidis E, et al. Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument. Ann R Coll Surg Engl 2021;103:471-7. [Crossref] [PubMed]
  4. Gavriilidis P, Askari A, de'Angelis N, et al. Appraisal of the Current Guidelines for Management of Malignant Left-Sided Colonic Obstruction Using the Appraisal of Guidelines Research and Evaluation II Instrument. Dig Surg 2021;38:177-85. [Crossref] [PubMed]
  5. Gavriilidis P, Askari A, Roberts KJ, et al. Appraisal of the current guidelines for management of cholangiocarcinoma-using the Appraisal of Guidelines Research and Evaluation II (AGREE II) Instrument. Hepatobiliary Surg Nutr 2020;9:126-35. [Crossref] [PubMed]
  6. Gavriilidis P, Roberts KJ, Askari A, et al. Evaluation of the current guidelines for resection of hepatocellular carcinoma using the Appraisal of Guidelines for Research and Evaluation II instrument. J Hepatol 2017;67:991-8. [Crossref] [PubMed]
Cite this article as: Gavriilidis P, Askari A, Gavriilidis E, Di Saverio S, Davies RJ, de’Angelis N. Limitations concerning evaluation of the current guidelines using the Appraisal of Guidelines Research and Evaluation II. Ann Transl Med 2023;11(10):373. doi: 10.21037/atm-2023-10

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