Evidence map›Paper›PMID 41199220›Full record

ArticleBMC medical research methodology2025

Assessing the quality for integrated guidelines: systematic comparison between the AGREE Ⅱ and AGREE-HS tools.

Gezhi Zhang, Danping Zheng, An Li, Weixuan Bai, Cuifang Liu, Xue Chen, Fangqi Liu, Mengyu Liu

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medical research methodology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Nutritional Risk Screening Recommendations for Critically Ill Patients: A Meta-Research Study and Quality Appraisal of Clinical Guidelines.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Gezhi ZhangInstitute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No.16 Inner South Street, Dongzhimen, Dongcheng District, Beijing, 100700, China.
Danping ZhengInstitute of Basic Theory of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, No.16 Inner South Street, Dongzhimen, Dongcheng District, Beijing, 100700, China.
An LiInstitute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No.16 Inner South Street, Dongzhimen, Dongcheng District, Beijing, 100700, China.
Weixuan BaiInstitute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No.16 Inner South Street, Dongzhimen, Dongcheng District, Beijing, 100700, China.
Cuifang LiuInstitute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No.16 Inner South Street, Dongzhimen, Dongcheng District, Beijing, 100700, China.
Xue ChenInstitute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No.16 Inner South Street, Dongzhimen, Dongcheng District, Beijing, 100700, China.
Fangqi LiuSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, No.35 Dingxi East Road, Chengguan District, Lanzhou, 730000, China.
Mengyu LiuInstitute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No.16 Inner South Street, Dongzhimen, Dongcheng District, Beijing, 100700, China. doctorlmy_satcm@163.com.

Funding

Independent Research Project of China Academy of Chinese Medical Sciences Z0740National Key Research and Development Program of China 2024YFC3505501National Natural Science Foundation of China 61771491
6 · The paper itself

Abstract

backgroundThis study evaluates WHO guidelines, particularly those integrating health systems guidance (HSG) and clinical practice guideline (CPG), by comparing the AGREE Ⅱ and AGREE-HS tools to identify differences in assessing integrated guidelines (IGs).

methodsThis exploratory evaluation used WHO epidemic guidelines. A comprehensive search in the WHO Institutional Repository for Information Sharing (IRIS) identified CPGs, HSGs, and IGs, which were assessed using AGREE Ⅱ and/or AGREE-HS tools.

resultsA total of 157 guidelines (20 CPGs, 101 HSGs, and 36 IGs) were included. CPGs scored significantly higher than IGs with AGREE Ⅱ (P < 0.001), but no significant difference was found using AGREE-HS (P = 0.185). Significant differences were found in multiple domains of AGREE Ⅱ (P < 0.05), including Scope and Purpose, Stakeholder Involvement, and Editorial Independence. AGREE-HS also revealed differences in cost-effectiveness and ethical criteria (P < 0.05).

conclusionCPGs were of significantly higher quality than IGs when assessed with AGREE Ⅱ, while IGs and HSGs showed similar quality with AGREE-HS. Despite consistent overall scores for IGs across both tools, specific item scores varied. These findings underscore the need for more transparent reporting in IGs, particularly regarding developer information, conflicts of interest, and patient guidance. Future work should focus on developing tools that integrate both AGREE Ⅱ and AGREE-HS to improve guideline evaluation.

Indexed as

Practice Guidelines as TopicCost-Benefit AnalysisHumansWorld Health OrganizationAGREE-HSAGREE ⅡClinical practice guidelineHealth systems guidanceQuality appraisal

Identifiers

PMID41199220
PMCPMC12593912

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.