[Comparison of the quality of two clinical practice guides in colorectal cancer using the AGREE System]. / Comparación de la calidad de dos guías de práctica clínica en el cáncer colorrectal mediante el sistema AGREE.

ABSTRACT

INTRODUCTION: Clinical practice guidelines (CPG) must be adapted to the population in which we apply them, therefore it is important that their quality is validated. AGREE Collaboration is a tool mainly designed for helping CPG providers and users in the evaluation of their methodological quality. MATERIAL AND METHOD: We have compared two colorectal cancer CPG (the original guidelines were prepared by Royal Collage of Surgeons of England (RCSE) and the other by the Valencian Society of Surgery (SVC). We used the AGREE Collaboration in both cases. This consists of 23 items organised into 6 areas. Each item is graded on a 4 point scale which measured the item accomplishment, from 4 points (complete agreement) to 1 point (complete disagreement). RESULTS: We observed no significant differences between both guidelines, except in 3 areas Area 2 (participation of people involved in the study) (SVC 66% vs RCSE 73%); Area 5 (Applicability) (SVC 52% vs RCSE 47%) and Area 6 (Editorial Independence) (SVC 58% vs RCSE 71%). Neither were there any significant differences between items, except in two cases Item 7 the question is Are the guidelines tested in target users?; Item 23 euroIs there any conflict of interests between members of the group which contributed to guidelines' development?. SVC guidelines performed 7 recommendations more than the English one, 3 of type A and 4 of type C. In both guidelines the most frequent type of recommendation is B (49% and 57% respectively). Types A and C are more frequent in SVC guidelines. CONCLUSIONS: a) If CPG exist, it is more efficient to adapt them to the local setting than to prepare them "de novo"; b) When new evidence is available, then this should be added to the adapted GPC and c) It is recommended to review compliance to the CPG in order to guaranteee their workability.