Evaluating the quality of cataract clinical practice guidelines: A systematic review using the AGREE II instrument

Clinical practice guidelines (CPGs) are crucial for providing evidence-based recommendations to improve patient care. Over the past 30 years, CPG development has progressed, particularly in addressing variations in care. However, significant disparities remain, especially in low- and middle-income countries. This systematic review aims to evaluate the methodological quality of cataract-related CPGs published between 2000 and 2023 by using the AGREE II instrument.

A comprehensive search identified 11 CPGs meeting eligibility criteria, assessed across six domains: Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability, and Editorial Independence.

CPGs from the United States, National Institute for Health and Care Excellence (NICE), and Peru showed high scores in Rigor of Development and Scope and Purpose domains. Conversely, guidelines from Asia, Chile, and Mexico were not recommended due to deficiencies across multiple domains. Applicability emerged as the weakest domain across all CPGs, indicating challenges in translating guidelines into practice.

These findings highlight variability in CPG quality, emphasizing the need for ongoing improvements, particularly in Stakeholder Involvement and Applicability domains. Continued efforts to enhance methodological rigor and practical applicability are crucial for improving quality of care in cataract management.