A critical appraisal of the quality of 18F-FDG PET/CT guidelines in oncology using the AGREE II tool: A EuroAIM initiative

Abstract

Purpose: to assess the quality of guidelines on clinical indications for the use of ¹⁸F-FDG PET/CT in oncology using the AGREE II tool.

Method: from March to May 2019, the current literature was searched to identify guidelines focused on clinical indications for the use of¹⁸F-FDG PET/CT in oncology. The quality of the selected guidelines was then assessed by four independent appraisers using the AGREE II tool, which is organized in six quality domains accounting for a total of 23 items. The agreement among appraisers was measured using the intraclass correlation coefficient (ICC) analysis.

Results: four guidelines were selected. Of these, one resulted of high quality (mean score 86.5 %), another showed an average quality (mean score 61.8 %), and the remaining two proved to be of low quality (mean scores of 53.3 and 45.7, respectively). With the exception of the high-quality guideline, critical domains were Domain 2 "Stakeholder involvement" (total mean score 56.28 + 15.9), Domain 3 "Rigor of development" (total mean score 43.48 + 27.6), Domain 5 "Applicability" (total mean score 46.90 + 19.4) and Domain 6 "Editorial independence" (total mean score 50.55 + 35.7). ICC values ranged from 0.939 to 0.995, indicating very good agreement among the four appraisers.

Conclusions: a heterogeneous quality of guidelines dealing with clinical indications for the use of ¹⁸F-FDG PET/CT in oncology emerged from our analysis. Further efforts should be made to improve the reporting of the applied methodology as well as to promote the applicability of guidelines into clinical practice.

Keywords: (18)F-FDG PET/CT; AGREE II; Evidence-based medicine; Guidelines; Hybrid imaging.