Assessment of guidelines for bariatric and metabolic surgery: a systematic review and evaluation using appraisal of guidelines for research and evaluation II (AGREE II)

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发表日期：

2024年6月18日

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Yung Lee,
Caroline Hircock,
Jerry Dang,
James Jung,
Boris Zevin,
Ahmad Elnahas,
Jigish Khamar,
Ashley Vergis,
Umair Tahir,
Krista Hardy,
Yasith Samarasinghe,
Richdeep Gill,
Jeffrey Gu,
Tyler McKechnie,
Radu Pescarus,
Laurent Biertho,
Elaine Lam,
Amy Neville,
James Ellsmere,
Shahzeer Karmali,
Timothy Jackson,
Allan Okrainec,
Aristithes Doumouras,
Matthew Kroh,
Dennis Hong

摘要

Background

In recent years, multiple guidelines on bariatric and metabolic surgery were published, however, their quality remains unknown, leaving providers with uncertainty when using them to make perioperative decisions. This study aims to evaluate the quality of existing guidelines for perioperative bariatric surgery care.

Methods

A comprehensive search of MEDLINE and EMBASE were conducted from January 2010 to October 2022 for bariatric clinical practice guidelines. Guideline evaluation was carried out using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) framework.

Results

The initial search yielded 1483 citations, of which, 26 were included in final analysis. The overall median domain scores for guidelines were: (1) scope and purpose: 87.5% (IQR: 57–94%), (2) stakeholder involvement: 49% (IQR: 40–64%), (3) rigor of development: 42.5% (IQR: 22–68%), (4) clarity of presentation: 85% (IQR: 81–90%), (5) applicability: 6% (IQR: 3–16%), (6) editorial independence: 50% (IQR: 48–67%), (7) overall impressions: 48% (IQR: 33–67%). Only six guidelines achieved an overall score >70%.

Conclusions

Bariatric surgery guidelines effectively outlined their aim and presented recommendations. However, many did not adequately seek patient input, state search criteria, use evidence rating tools, and consider resource implications. Future guidelines should reference the AGREE II framework in study design.