[International comparison of 19 clinical guideline programs--a survey of the AGREE Collaboration]

Clinical practice guidelines are being developed in many countries throughout the world to improve quality of patient care. However, the methods used to develop guidelines vary among organisations. Therefore an international task group, the AGREE (Appraisal Guideline Research and Evaluation Europe) Collaboration, started in 1998 to work on the harmonisation and coordination of guideline development. Within this context a survey of national guideline programmes was conducted. Nineteen programmes from nine European countries, Australia, Canada, New Zealand and United States were described using a questionnaire. The items concerned the type of organisation, scope and purpose of the guidelines, people involved, methodology, products, implementation, evaluation, update procedure, and future plans. The results of this survey revealed a growing international consensus on the essential features of good guideline programmes. Most guideline programmes combine an evidence-based approach with informal and/or formal consensus procedures. No significant differences were found between governmental agencies and professional organisations. The budget for developing a single guideline varies from 10,000 to 200,000 EURO.