Evaluation and analysis of the current guidelines for acute pancreatitis using Appraisal of Guidelines for Research and Evaluation Ⅱ

Objective To investigate the quality of the guidelines for acute pancreatitis in China and foreign countries using Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Methods According to inclusion and exclusion criteria, Wanfang Data, CNKI, VIP, Pub Med, Cochrane, and Elsevier were searched for the guidelines for the diagnosis and treatment of acute pancreatitis published from 2005 to 2016. As for the guidelines included, the information on the institutions that issued the guidelines, the basis for evidence evaluation, and the year of issuance was collected. The AGREE II instrument was used to evaluate the quality of the guidelines included in this study. The independent-samples nonparametric Mann-Whitney U test was used to compare the scores of guidelines in China and foreign countries. Results A total of 10 guidelines/consensus statements were included, among which 4 were published by China and 6 were published by foreign countries. The AGREE II results of 10 guidelines evaluated by three reviewers had an interclass correlation coefficient of> 0. 75 (all P < 0. 05) , which showed good consistency. The evaluation results showed that these guidelines had high mean scores of“Scope and Purpose”and“Clarity of Presentation” (50. 37% and 53. 15%, respectively) , and the guidelines in foreign countries had significantly higher mean scores than the guidelines in China (64. 51% vs 29. 16%, Z =-2. 558, P = 0. 011; 73. 77% vs 22. 22%, Z =-2. 574, P = 0. 010) . The guidelines had low mean scores of “Stakeholder Involvement”, “Rigour of Development”, and“Applicability” (28. 70%, 30. 49%, and 19. 17%, respectively) , and the guidelines in foreign countries had a significantly higher mean score of“Rigour of Development”than the guidelines in China (48. 96% vs 2. 78%, Z =-2. 557, P = 0. 011) . All guidelines had a mean score of“Editorial Independence”of 41. 39%, and the guidelines in foreign countries had a significantly higher mean score than the guidelines in China (68. 98% vs 0, Z =-2. 648, P = 0. 008) . The recommendation levels of the guidelines in China and foreign countries were C and B, respectively. Conclusion “Stakeholder Involvement”, “Rigour of Development”, and“Applicability”of the guidelines for acute pancreatitis need to be improved. The guidelines for acute pancreatitis in foreign countries are evidence-based guidelines and can be used after appropriate revision. The overall quality of the guidelines in China are inferior to those in foreign countries in the aspects of “Rigour of Development”, “Applicability”, and“Editorial Independence”, and therefore, it is recommended to further regulate the drafting and editing of evidence-based guidelines for acute pancreatitis in China, in order to promote the standard diagnosis and treatment of acute pancreatitis in China.