Quality of guidelines for hyperthyroidism: systematic quality assessment using the AGREE II tool

Area of Science:

• Endocrinology
• Clinical Practice Guidelines
• Evidence-Based Medicine

Background:

• Hyperthyroidism management relies on clinical practice guidelines.
• The quality and consistency of these guidelines are crucial for effective patient care.
• Systematic assessment is needed to identify variations and areas for improvement.

Purpose of the Study:

• To systematically evaluate the quality of hyperthyroidism management guidelines.
• To analyze the recommendations and supporting evidence across different guidelines.
• To identify factors contributing to variations in guideline recommendations.

Main Methods:

• A systematic literature search identified hyperthyroidism treatment guidelines.
• The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool assessed guideline quality.
• The Measurement Scale of Rate of Agreement (MSRA) evaluated agreement among guidelines.

Main Results:

• Eleven hyperthyroidism guidelines were identified and assessed.
• Guidelines from ATA, JTA, ETA (2022), and CMA scored >60% and are clinically recommended.
• Significant variations in recommendations exist due to differing diagnostic emphasis, target populations, evidence selection, and geography.

Conclusions:

• The quality and recommendations of hyperthyroidism guidelines are inconsistent.
• Addressing the causes of these inconsistencies can enhance future guideline development.
• Improving guideline quality is essential for optimizing hyperthyroidism patient management.