Appraisal of clinical practice guidelines for salivary gland cancer management utilizing AGREE II instrument

Kaiwen Chen; Young Lee; Jonathan P Kuriakose; Najm S Khan; Alvaro Moreira; Karthik Rajasekaran

doi:10.1016/j.amjoto.2024.104285

Appraisal of clinical practice guidelines for salivary gland cancer management utilizing AGREE II instrument

Am J Otolaryngol. 2024 Apr 8;45(4):104285. doi: 10.1016/j.amjoto.2024.104285. Online ahead of print.

Authors

Kaiwen Chen¹, Young Lee², Jonathan P Kuriakose³, Najm S Khan⁴, Alvaro Moreira⁵, Karthik Rajasekaran⁶

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America. Electronic address: https://twitter.com/KChenTweets.
² Central Michigan University College of Medicine, Mount Pleasant, MI, United States of America.
³ Department of Otolaryngology - Head and Neck Surgery, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America; Department of Otolaryngology - Head & Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America. Electronic address: https://twitter.com/kuriousjon96.
⁴ Department of Otolaryngology - Head and Neck Surgery, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America. Electronic address: https://twitter.com/Najm__Khan.
⁵ Department of Pediatrics, University of Texas Health-San Antonio, San Antonio, TX, United States of America.
⁶ Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America. Electronic address: Karthik.rajasekaran@pennmedicine.upenn.edu.

PMID: 38657536
DOI: 10.1016/j.amjoto.2024.104285

Abstract

Objective: Salivary gland cancers (SGC) are rare neoplasms which comprise 1-5 % of all head and neck cancers. SGCs can be managed by resection, radiosurgery, chemotherapy, or a combination of these. Our team appraised the quality of clinical practice guidelines (CPGs) for SGC treatment and management using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument.

Data sources: PubMed, Scopus, & EMBASE were reviewed for CPGs regarding SGC management from database inception to January 1st, 2023.

Review methods: The AGREE-II instrument was used by 4 reviewers to independently evaluate guidelines. Domain scores were generated with a satisfactory threshold being >60 % - a "high" quality CPG required >4 satisfactory domains. Intraclass correlation coefficients (ICCs) were used, via R 4.2.1., to determine inter-reviewer variability.

Results: Literature review identified 645 articles, with six being included after applying inclusion and exclusion criteria. Of the six included articles, one CPG was "high" quality and 5 were "low" quality. The domains with the highest scores were "Editorial Independence" (72.57 ± 36.60) and "Clarity and Presentation" (63.19 ± 26.08), while the lowest were "Rigor of Development" (34.03 ± 30.63) and "Applicability" (30.21 ± 30.46). ICC scores for each domain ranged from 0.937 to 0.983, indicating a high level of inter-rater agreement.

Conclusion: This study found that most CPGs for the treatment and management of SGC were of "low" quality, with only one guideline being considered "high" quality based on the standard set by the AGREE-II instrument. These findings indicate that there is a high level of variability and little standardization when it comes to the quality of CPGs.

Keywords: AGREE II; Clinical practice guidelines; Head and neck surgery; Review; Salivary gland cancer.