A Comparative Analysis of the European and American Venous Disease Guidelines: Bridging Evidence to Practice Using...

Chronic venous disease guidelines are vital for standardizing care, yet their methodological quality varies among societies. In Latin America, the European Society of Vascular Surgery (ESVS) and Society of Vascular Surgery (SVS) guidelines are widely used but have not been directly compared. This study uses the Appraisal of Guidelines for Research and Evaluation II (AGREE II), a validated tool, to assess and compare their quality as rated by experts, revealing strengths and limitations.

Vascular surgeons from Spanish-speaking countries evaluated the 2022 SVS and ESVS venous disease guidelines using the AGREE II instrument. Participants met predefined expertise criteria and completed paired assessments. Scores were compared using Wilcoxon signed-rank tests, with domain scores calculated as percentages and interrater reliability assessed using intraclass correlation coefficients (ICCs). Statistical significance was set at P < 0.05.

Thirty-two vascular surgeons (47.1% response rate) participated, predominantly from Latin America (93.8%). The ESVS guideline scored significantly higher than SVS in scope and purpose (95.2% vs. 85.7%, P = 0.017), stakeholder involvement (85.7% vs. 76.2%, P = 0.036), editorial independence (85.7% vs. 64.3%, P = 0.003), and overall median score (84.5% vs. 77.0%, P = 0.005). Both guidelines showed robust interrater reliability (ESVS ICC = 0.90, SVS ICC = 0.88).

Both guidelines provide valuable guidance, but improvements are needed. The ESVS guideline excels in clarity but lacks practical applicability, while the SVS guideline needs greater transparency and stakeholder involvement. Refining these aspects can enhance their impact on vascular surgery.