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Abstract：
BACKGROUND: The Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within 6 domains and 2 overall assessments (1. overall guideline quality; 2. recommendation for use). The aim of this systematic review was twofold. Firstly, to investigate how often AGREE II users conduct the 2 overall assessments. Secondly, to investigate the influence of the 6 domain scores on each of the 2 overall assessments.
METHODS: A systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: \"yes\", \"yes, with modifications\", \"no\") was examined using a multinomial regression model.
RESULTS: 118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development) having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 (\"yes\" vs. \"no\") and Domains 3 and 5 (\"yes, with modifications\" vs. \"no\").
CONCLUSIONS: The 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis of the individual domains could clarify their importance in terms of guideline quality. Moreover, AGREE II should require users to transparently present how they conducted the assessments.
METHODS: A systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: \"yes\", \"yes, with modifications\", \"no\") was examined using a multinomial regression model.
RESULTS: 118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development) having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 (\"yes\" vs. \"no\") and Domains 3 and 5 (\"yes, with modifications\" vs. \"no\").
CONCLUSIONS: The 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis of the individual domains could clarify their importance in terms of guideline quality. Moreover, AGREE II should require users to transparently present how they conducted the assessments.
摘要：
背景：评估研究与评估指南（AGREE）II工具是最常用的指南评估工具。它包括在6个领域内组织的23个评估标准（项目）和2个总体评估（1。总体指南质量;2.建议使用)。本系统综述的目的是双重的。首先,调查AGREEII用户进行两次总体评估的频率。其次,调查6个领域分数对2个总体评估中每一个的影响。
方法：对报告AGREEII指南评估的出版物进行了系统的书目检索。使用多元线性回归模型检查了6个领域得分对指南质量总体评估的影响。它们对使用建议的影响(可能的答案:\"是\",\"是的,修改为\“，\“no\”)使用多项回归模型进行检查。
结果：确认了118份相关出版物，包括1453份指南。77.1%的出版物报告了至少一次总体评估的结果，但只有32.2%的人报告了两项总体评估的结果。回归分析的结果显示，所有领域对总体指南质量的影响具有统计学意义，领域3(发展的严谨性)具有最强的影响力。对于使用建议，结果显示域3至5的影响显著(“是”与\"no\")和域3和5(\"是,与修改“与\"no\")。
结论：指南评估人员低估了AGREEII的2项总体评估。域3和5对两项总体评估的结果影响最大，而其他领域有不同的影响。在规范的方法中，我们的研究结果可作为AGREEII中各个领域权重的指导,以使总体评估更加客观.或者，对各个领域进行更强的内容分析可以阐明它们在指南质量方面的重要性.此外，协议二应要求用户透明地展示他们是如何进行评估的。
方法：对报告AGREEII指南评估的出版物进行了系统的书目检索。使用多元线性回归模型检查了6个领域得分对指南质量总体评估的影响。它们对使用建议的影响(可能的答案:\"是\",\"是的,修改为\“，\“no\”)使用多项回归模型进行检查。
结果：确认了118份相关出版物，包括1453份指南。77.1%的出版物报告了至少一次总体评估的结果，但只有32.2%的人报告了两项总体评估的结果。回归分析的结果显示，所有领域对总体指南质量的影响具有统计学意义，领域3(发展的严谨性)具有最强的影响力。对于使用建议，结果显示域3至5的影响显著(“是”与\"no\")和域3和5(\"是,与修改“与\"no\")。
结论：指南评估人员低估了AGREEII的2项总体评估。域3和5对两项总体评估的结果影响最大，而其他领域有不同的影响。在规范的方法中，我们的研究结果可作为AGREEII中各个领域权重的指导,以使总体评估更加客观.或者，对各个领域进行更强的内容分析可以阐明它们在指南质量方面的重要性.此外，协议二应要求用户透明地展示他们是如何进行评估的。
