The Evaluation of Guideline Quality in Rheumatic Diseases

We evaluated the quality of selected rheumatology guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Guidelines were also assessed to determine if Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology had been used during development and for the inclusion of health inequity considerations. Only half of the guidelines used the GRADE methodology, and this was associated with higher AGREE II ratings in the Rigor of Development domain. Ongoing areas identified for improvement included more meaningful engagement of patients in guideline panels, increased transparency of the management of conflicts of interest, improved reporting of strategies for guideline implementation, and increased consideration of the health equity implications throughout guideline development and implementation.