Table 2 Quality appraisal of guidelines using the STAR tool
Item | Item score | Rating n/N (%) |
|---|---|---|
Overall | 100.0 | 161/390 (41) |
Domain 1: Registry | 5.0 | 0/20 (0) |
1. Register the guideline on an appropriate platform. | 1.5 | 0/10 (0) |
2. Provide information about the registry platform and registry ID of the guideline. | 3.5 | 0/10 (0) |
Domain 2: Protocol | 5.0 | 0/20 (0) |
3. Provide details of the guideline protocol. | 1.9 | 0/10 (0) |
4. Identify how the guideline protocol is accessible from an open-source platform (e.g., guideline registry platform or website). | 3.1 | 0/10 (0) |
Domain 3: Funding | 3.2 | 12.5/30 (42) |
5. Describe the sources of funding for the development of the guideline. | 1.0 | 5.5/10 (55) |
6. Describe the role of funder(s) in the guideline development. | 0.9 | 4/10 (40) |
7. Declare that the funder(s) did not influence the guideline’s recommendations. | 1.3 | 3/10 (30) |
Domain 4: Guideline development groups | 7.3 | 22/50 (44) |
8. List the institutional affiliations of all individuals involved in developing the guideline. | 0.9 | 10/10 (100) |
9. Describe the composition of the development groups. | 1.0 | 3.5/10 (35) |
10. Describe the responsibilities of all individuals or sub-groups involved in developing the guideline. | 1.3 | 2/10 (20) |
11. Identify experts from at least two disciplines in addition to the guideline’s topic who took part in the development. | 1.3 | 5/10 (50) |
12. Identify guideline methodologists or experts in evidence-based medicine who took part in the development. | 2.8 | 1.5/10 (15) |
Domain 5: Conflicts of interest | 9.2 | 14/20 (70) |
13. Describe whether conflicts of interest existed. | 4.4 | 9/10 (90) |
14. Indicate information about the evaluation and management of conflicts of interest. | 4.8 | 5/10 (50) |
Domain 6: Clinical questions | 8.9 | 30/40 (75) |
15. Identify the clinical questions that the guideline focuses on. | 6.4 | 10/10 (100) |
16. Introduce the methods of collecting clinical questions, such as literature search, survey of users, or consultation of experts. | 2.5 | 9/10 (90) |
17. Indicate how the clinical questions were selected and sorted. | 3.4 | 6.5/10 (65) |
18. Format clinical questions in PICO (population/patients, intervention, control/comparator, and outcome) or other formats. | 4.8 | 4.5/10 (45) |
Domain 7: Evidence | 25.1 | 36/90 (40) |
19. Identify the references for evidence supporting the main recommendations. | 1.7 | 10/10 (100) |
20. State to the details of the systematic search (e.g., names of databases, selection criteria, search strategies). | 2.2 | 2/10 (20) |
21. Indicate the inclusion and exclusion criteria of research evidence. | 1.5 | 2/10 (20) |
22. Assess the risk of bias or methodological quality of the included studies. | 1.9 | 5/10 (50) |
23. Summarize and analyze the research evidence. | 2.1 | 0/10 (0) |
24. Indicate the standard used to grade the evidence quality. | 2.2 | 4/10 (40) |
25. Provide the GRADE evidence profile or summary of the results of evidence grading. | 2.4 | 2/10 (20) |
26. Provide reference to the full text of systematic reviews. | 1.7 | 1/10 (10) |
27. Identify the clinical questions with insufficient evidence (low quality) and indicate future research directions to collect more evidence. | 1.2 | 10/10 (100) |
Domain 8: Consensus method | 10.7 | 3/30 (10) |
28. Indicate the specific method(s) used to reach consensus (e. g., the Delphi method, Nominal group technique, or informal approaches). | 5.1 | 2/10 (20) |
29. Describe the criteria to inform decisions other than the certainty of the evidence (e.g., resource requirements, preferences and values of patients, cost–benefit balance, accessibility, health equity, acceptability). 30. Provide the records of the consensus process. | 3.8 | 1/10 (10) |
30. Provide the records of the consensus process. | 1.8 | 0/10 (0) |
Domain 9: Recommendations | 17.1 | 31/40 (78) |
31. Make the recommendations clearly identifiable (e.g., in a table, or using enlarged or bold fonts). | 4.1 | 9/10 (90) |
32. Indicate the strength of all recommendations. | 6.3 | 4/10 (40) |
33. Provide the explanations for all recommendations. | 3.9 | 9/10 (90) |
34. Indicate the considerations (e.g., adverse effects) in clinical practice when implementing the recommendations. | 2.8 | 9/10 (90) |
Domain 10: Accessibility | 7.3 | 10.5/40 (26) |
35. Make the guideline accessible through multiple platforms (e. g., guideline libraries, conference presentations, and websites). | 2.5 | 2.5/10 (25) |
36. Provide tailored editions of the guidelines for different groups of target users (e.g., patients, public, primary care physicians). | 1.4 | 0/10 (0) |
37. Present the guideline or recommendations visually, such as with figures or videos. | 1.1 | 0/10 (0) |
38. Make the full guideline downloadable free of charge. | 2.3 | 8/10 (80) |
Domain 11: Other | 1.2 | 2/10 (20) |
39. Provide a flowchart of clinical pathways reflecting the recommendations. | 1.2 | 2/10 (20) |