Table 2.
Appraisal of Guidelines for Research and Evaluation (AGREE) II results for clinical practice guidelines.
| Domains | Clinical Practice Guidelines | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASPEN [16] |
DAA [17] |
DGEM [18] |
EBPG [19] |
EDTNA-ERCA [20] |
ESPEN (EN) [21] |
ESPEN (PN) [22] |
GARIN [23] |
KDOQI [24] |
SIN-ANDID-ANED [25] |
The Renal Association [26] |
|
| 1. SCOPE AND PURPOSE | 34.7 | 88.9 | 88.9 | 0.00 | 62.5 | 77.8 | 81.9 | 86.1 | 88.9 | 55.6 | 5.6 |
| a. Overall objectives | 75.0 | 85.7 | 82.1 | 14.3 | 75.0 | 71.4 | 89.3 | 89.3 | 89.3 | 60.7 | 25.0 |
| b. Health questions | 17.9 | 96.4 | 89.3 | 14.3 | 53.6 | 85.7 | 89.3 | 89.3 | 100 | 67.9 | 14.3 |
| c. Population to apply | 39.3 | 89.3 | 100 | 14.3 | 75.0 | 85.7 | 75.0 | 89.3 | 92.0 | 57.1 | 17.9 |
| 2. STAKEHOLDER INVOLVEMENT | 62.5 | 63.9 | 44.4 | 16.7 | 34.7 | 36.1 | 12.5 | 15.3 | 51.4 | 43.1 | 18.1 |
| a. Guideline development group | 85.7 | 75.0 | 64.3 | 53.6 | 32.1 | 53.6 | 42.9 | 39.3 | 100 | 71.4 | 32.1 |
| b. Views and preferences of target population | 28.6 | 71.4 | 14.3 | 17.9 | 32.1 | 14.3 | 14.3 | 14.5 | 17.9 | 53.6 | 14.3 |
| c. Users of guidelines | 89.3 | 60.7 | 78.6 | 14.3 | 67.9 | 67.9 | 17.9 | 28.6 | 57.1 | 28.6 | 42.9 |
| 3. RIGOR OF DEVELOPMENT | 31.3 | 30.2 | 48.9 | 21.9 | 13.0 | 36.5 | 18.2 | 47.4 | 72.4 | 3.6 | 33.3 |
| a. Research methodology | 32.1 | 32.1 | 82.1 | 14.3 | 14.3 | 17.9 | 14.3 | 50.0 | 96.4 | 14.3 | 60.7 |
| b. Selecting criteria | 14.3 | 17.9 | 14.2 | 14.3 | 14.3 | 14.3 | 17.9 | 75.0 | 100 | 14.3 | 14.3 |
| c. Strengths and limitations of evidence | 14.3 | 14.3 | 14.3 | 28.6 | 14.3 | 14.3 | 17.9 | 85.7 | 85.7 | 14.3 | 42.9 |
| d. Formulating methods | 46.4 | 42.9 | 50.0 | 14.3 | 17.9 | 39.3 | 25.0 | 32.1 | 82.1 | 14.3 | 53.6 |
| e. Health benefits, side effects and risks stated in recommendations | 75.0 | 14.3 | 92.9 | 82.1 | 67.9 | 75.0 | 75.0 | 57.1 | 32.1 | 25.0 | 25.0 |
| f. Explicit link of recommendations | 89.3 | 82.1 | 92.9 | 82.1 | 46.4 | 96.4 | 60.7 | 96.4 | 100 | 28.6 | 71.4 |
| g. Review of guideline | 42.9 | 57.1 | 14.3 | 14.3 | 14.3 | 28.6 | 14.3 | 28.6 | 100 | 14.3 | 60.7 |
| h. Updating procedure | 14.3 | 60.7 | 89.3 | 14.3 | 14.3 | 78.6 | 14.3 | 14.3 | 14.3 | 14.3 | 14.3 |
| 4. CLARITY OF PRESENTATION | 52.8 | 84.7 | 100 | 86.1 | 91.7 | 94.4 | 91.7 | 94.4 | 98.6 | 33.3 | 68.1 |
| a. Specific and unambiguous recommendations | 67.9 | 83.3 | 100 | 89.3 | 96.4 | 89.3 | 100 | 96.4 | 100 | 46.4 | 85.7 |
| b. Different options for management | 14.3 | 92.9 | 100 | 75.0 | 85.7 | 96.4 | 96.4 | 89.3 | 96.4 | 25.0 | 60.7 |
| c. Identifiable key recommendations | 96.4 | 96.4 | 100 | 100 | 96.4 | 100 | 82.1 | 100 | 100 | 57.1 | 71.4 |
| 5. APPLICABILITY | 0.0 | 11.5 | 12.5 | 27.1 | 36.5 | 4.2 | 33.3 | 25.0 | 62.5 | 0.0 | 0.0 |
| a. facilitators and barriers of application | 14.3 | 14.3 | 14.3 | 17.9 | 32.1 | 14.3 | 14.2 | 14.3 | 28.6 | 14.3 | 14.3 |
| b. guideline implementation advice and tools | 14.3 | 21.4 | 14.3 | 60.7 | 67.9 | 14.3 | 67.9 | 57.1 | 96.4 | 14.3 | 14.3 |
| c. Resource implications | 14.3 | 21.4 | 14.3 | 28.5 | 28.6 | 14.3 | 14.3 | 17.9 | 57.1 | 14.3 | 14.3 |
| d. Monitoring and/or auditing criteria | 14.3 | 39.3 | 57.1 | 42.9 | 53.6 | 28.6 | 75.0 | 53.6 | 89.3 | 14.3 | 14.3 |
| 6. EDITORIAL INDEPENDENCE | 35.4 | 100 | 47.9 | 0.00 | 36.5 | 95.8 | 6.3 | 39.6 | 91.7 | 50.0 | 47.9 |
| a. Views of funding body | 75.0 | 100 | 21.4 | 14.3 | 17.9 | 96.4 | 14.3 | 82.1 | 85.7 | 42.9 | 14.3 |
| b. Conflicts of interests | 14.3 | 100 | 89.3 | 14.3 | 17.9 | 96.4 | 25.0 | 14.3 | 100 | 71.4 | 96.4 |
| OVERALL QUALITY | Low | Moderate | Low | Low | Low | Moderate | Low | Low | Moderate | Low | Low |
| RECOMMENDATIONS | |||||||||||
| Recommended | |||||||||||
| With modifications | X | X | X | ||||||||
| Not recommended | X | X | X | X | X | X | X | X | |||
All results are presented as percentage scores. Total score of each domain and the highest score of each category are presented in bold font. EN: Enteral nutrition; PN: Parenteral nutrition. AoND: Academy of Nutrition and Dietetics, ASPEN: American Society for Parenteral and Enteral Nutrition, DAA: Dietitians Association of Australia, DGEM: Deutsche Gesellschaft für Ernährungsmedizin-German Society for Nutritional Medicine, EBPG: European Best Practice Guidelines, EDTNA-ERCA: European Dialysis and Transplantation Nurses Association/European Renal Care Association, ESPEN: European Society for Clinical Nutrition and Metabolism, KDOQI: Kidney Disease Outcomes Quality Initiative, GARIN: Andalusian Group for Nutrition Reflection and Investigation.