. 2024 Mar 11;38(9):1722–1733. doi: 10.1038/s41433-024-03008-1

Table 4.

Summary of Appraisers’ Comments on the Retinal Vein Occlusion Clinical Practice Guidelines assessed, organised by AGREE II Domains.

AGREE II domain	Strength	Weaknesses
1. Scope and Purpose	• The objective is well defined only in one CPG (RCO). • Population to whom the guideline is meant to apply, is partially reported (RCO, PPP, CEC).	• Guideline objective is partially or not clearly stated (EURETINA, PPP, SERV, CEC) • Partial statements about health questions are reported (RCO). • Health questions are not clearly stablished (EURETINA, SERV, CEC). • Population to whom the guideline is meant to apply, is not specifically described (EURETINA, SERV).
2. Stakeholder Involvement	• Guideline development group included individuals from relevant professional groups: Methodologist (PPP) or Haematologist (RCO). • Target users were reported (RCO, PPP, CEC).	• Guideline development group does not include individuals from all relevant professional groups (no methodologist, no patient representative) (RCO, EURETINA, SERV, PPP, SERV, CEC). • Target users were not reported (EURETINA, SERV). • No reference to views and preferences of the target population was reported (RCO, EURETINA, SERV, CEC, partially in the PPP).
3. Rigour of development	• Details of the search strategy used were reported (RCO, PPP, CEC). • Some criteria for selecting the evidence are described (PPP). • An explicit link between the recommendations and the supporting evidence was reported (RCO, EURETINA, partially in SERV and CEC). • The guideline was externally reviewed (PPP, SERV). • Health benefits, side effects, and risks were considered (RCO, CEC, partially in SERV). • Update details are reported (RCO and PPP).	• Criteria for selecting the evidence was not clearly described (RCO, EURETINA, SERV, CEC). • No clear description of the strengths and limitations of the body of evidence (RCO, EURETINA, PPP, SERV, CEC). • No clear description of the methods for formulating the recommendations (RCO, EURETINA, PPP, SERV, CEC). • No clear description of health benefits, side effects, and risks (RCO, EURETINA,). • No external review details were reported (RCO, EURETINA, CEC). • No update details were reported (SERV, EURETINA, CEC).
4. Clarity of presentation	• Key recommendations are easily identifiable (RCO, PPP, SERV, CEC). • Recommendations are specific and unambiguous, different options for management of the condition or health issue are clearly presented (RCO, EURETINA, SERV, CEC; highlighted findings and recommendations for care in PPP).	• Key recommendations are not easily identifiable only in one CPG (EURETINA).
5. Applicability	• Present monitoring and/or auditing criteria (RCO reports ‘service evaluation measures’, PPP describes some criteria for monitoring and/or auditing). • Includes several algorithms (SERV, CEC). • An economic section is included (PPP, CEC). • Facilitators and barriers to its application were described (PPP, CEC). • Guideline includes recommendations to put into practice (PPP).	• Don’t describe facilitators and barriers to its application (RCO, EURETINA, SERV). • The guideline doesn’t provide advice and/or tools on how the recommendations can be put into practice (RCO, EURETINA, SERV). • Potential resource implications of applying the recommendations have not been considered (RCO, EURETINA, SERV). • No monitoring and/or auditing criteria is included (EURETINA, CEC).
6. Editorial independence	• Views of the funding body were reported (PPP, partially in RCO) • Competing interests of guideline development group members have been recorded and addressed (RCO, EURETINA, PPP, SERV). • Guideline report details about funding body (CEC).	• No report of the views of the funding body was reported (EURETINA, SERV). • No description of competing interests was reported (CEC).
7. Overall Guideline Assessment	• RCO: 3, with modification. • EURETINA: 3, with modification. • PPP: 4, with modification. • SERV: 3, with modification. • CEC: 3, with modification.

AGREE II domain

Strength

Weaknesses

1. Scope and Purpose

• The objective is well defined only in one CPG (RCO).

• Population to whom the guideline is meant to apply, is partially reported (RCO, PPP, CEC).

• Guideline objective is partially or not clearly stated (EURETINA, PPP, SERV, CEC)

• Partial statements about health questions are reported (RCO).

• Health questions are not clearly stablished (EURETINA, SERV, CEC).

• Population to whom the guideline is meant to apply, is not specifically described (EURETINA, SERV).

2. Stakeholder Involvement

• Guideline development group included individuals from relevant professional groups: Methodologist (PPP) or Haematologist (RCO).

• Target users were reported (RCO, PPP, CEC).

• Guideline development group does not include individuals from all relevant professional groups (no methodologist, no patient representative) (RCO, EURETINA, SERV, PPP, SERV, CEC).

• Target users were not reported (EURETINA, SERV).

• No reference to views and preferences of the target population was reported (RCO, EURETINA, SERV, CEC, partially in the PPP).

3. Rigour of development

• Details of the search strategy used were reported (RCO, PPP, CEC).

• Some criteria for selecting the evidence are described (PPP).

• An explicit link between the recommendations and the supporting evidence was reported (RCO, EURETINA, partially in SERV and CEC).

• The guideline was externally reviewed (PPP, SERV).

• Health benefits, side effects, and risks were considered (RCO, CEC, partially in SERV).

• Update details are reported (RCO and PPP).

• Criteria for selecting the evidence was not clearly described (RCO, EURETINA, SERV, CEC).

• No clear description of the strengths and limitations of the body of evidence (RCO, EURETINA, PPP, SERV, CEC).

• No clear description of the methods for formulating the recommendations (RCO, EURETINA, PPP, SERV, CEC).

• No clear description of health benefits, side effects, and risks (RCO, EURETINA,).

• No external review details were reported (RCO, EURETINA, CEC).

• No update details were reported (SERV, EURETINA, CEC).

4. Clarity of presentation

• Key recommendations are easily identifiable (RCO, PPP, SERV, CEC).

• Recommendations are specific and unambiguous, different options for management of the condition or health issue are clearly presented (RCO, EURETINA, SERV, CEC; highlighted findings and recommendations for care in PPP).

• Key recommendations are not easily identifiable only in one CPG (EURETINA).

5. Applicability

• Present monitoring and/or auditing criteria (RCO reports ‘service evaluation measures’, PPP describes some criteria for monitoring and/or auditing).

• Includes several algorithms (SERV, CEC).

• An economic section is included (PPP, CEC).

• Facilitators and barriers to its application were described (PPP, CEC).

• Guideline includes recommendations to put into practice (PPP).

• Don’t describe facilitators and barriers to its application (RCO, EURETINA, SERV).

• The guideline doesn’t provide advice and/or tools on how the recommendations can be put into practice (RCO, EURETINA, SERV).

• Potential resource implications of applying the recommendations have not been considered (RCO, EURETINA, SERV).

• No monitoring and/or auditing criteria is included (EURETINA, CEC).

6. Editorial independence

• Views of the funding body were reported (PPP, partially in RCO)

• Competing interests of guideline development group members have been recorded and addressed (RCO, EURETINA, PPP, SERV).

• Guideline report details about funding body (CEC).

• No report of the views of the funding body was reported (EURETINA, SERV).

• No description of competing interests was reported (CEC).

7. Overall Guideline Assessment

• RCO: 3, with modification.

• EURETINA: 3, with modification.

• PPP: 4, with modification.

• SERV: 3, with modification.

• CEC: 3, with modification.

RCO Royal College of Ophthalmologists, EURETINA European Society of Retina Specialists, PPP Preferred Practice Pattern, SERV Sociedad Española de Retina y Vítreo, CEC Canadian Expert Consensus.