A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett’s Esophagus Using the AGREE II Tool
Bibliographic record
Abstract
BACKGROUND: Several clinical practice guidelines (CPGs) exist for managing Barrett's esophagus (BE). However, the methodological quality of these CPGs is not known. To summarize the methodological quality of CPGs, we performed a critical appraisal of all available CPGs for the management of BE published from January 2018 to February 2023. METHODS: A comprehensive search of EMBASE and PubMed was conducted to identify eligible CPGs published from January 1, 2018, until February 24, 2023, addressing the management of BE. The Canadian Agency for Drugs and Technologies broad filter was also utilized in the search. The quality of the CPGs was independently assessed and evaluated by 2 reviewers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, with domain scores showing good quality being >80% and sufficient quality being >60%. The search yielded 652 citations, of which 5 CPGs met eligibility. RESULTS: Three CPGs were published by gastroenterology societies in the United States and 2 in Europe. The overall median score for the AGREE II domain was 100% for scope and purpose, 93% for stakeholder involvement, 93% for rigor of development, 93% for clarity of presentation, 75% for applicability, and 75% for editorial independence. CONCLUSION: The findings from our study show that there is significant variability in the methodological quality of the CPGs for the management of BE across different domains. The application of the AGREE II tool can help CPG developers in improving the methodological rigor and applicability of CPGs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.060 | 0.639 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.012 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.007 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".