• Zhiyun He, Hongliang Tian, Ailin Song, Lan Jin, Xiaona Zhou, Xiaoye Liu, Wei Guo, and Zhongtao Zhang.
• From the General Surgery Department (ZH, LJ, XZ, XL, WG, ZZ), Beijing Friendship Hospital, Beijing; General Surgery Department (ZH, AS), Lanzhou University Second Hospital, Lanzhou, Gansu; and Research Institute of General Surgery (HT), Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China.
• Medicine (Baltimore). 2015 Mar 1; 94 (12): e635.

AbstractClinical practice guidelines (CPGs) play an important role in health care. The guideline development process should be precise and rigorous to ensure that the results are reproducible and not vague. To determine the quality of guidelines, the Appraisal of Guidelines and Research and Evaluation (AGREE) instrument was developed and introduced. The objective of this study is to assess the methodological quality of CPGs on pancreatic cancer. Five databases (included MEDLINE and EMBASE) and guideline websites were searched till April, 2014. The methodological quality of the guidelines was assessed by 4 authors independently using the AGREE II instrument. From 2526 citations, 21 relevant guidelines were included. The overall agreement among reviewers was moderate (intraclass correlation coefficient = 0.86, 95% confidence interval 0.64-0.96). The mean scores were moderate for the domains "scope and purpose" and "clarity of presentation"; however, they were low for the domains "stakeholder involvement" (31.22), "rigor of development", "applicability", and "editorial independence". These domain scores were lower when compared with international levels. There are 5 (23.81%) guidelines that described the systematic methods for searching. Moreover, only 5 (23.81%) guidelines reported that methodological expertise were included in the guideline developing teams. The quality and transparency of the development process and the consistency in the reporting of pancreatic cancer guidelines need to be improved. Many other methodological disadvantages were identified. In the future, pancreatic cancer CPGs should base on the best available evidence rigorously developed and reported. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision making in this field.

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