Appraisal of congenital heart disease guidelines and consensus

This is a systematic review of methodological and reporting quality of CHD guidelines and consensus statements.To systematically appraise the methodological and reporting quality of global congenital heart disease (CHD) guidelines and consensus statements, identifying key areas for improvement with implications for international guideline development.

We searched Chinese and English databases up to November 2025. Four appraisers independently evaluated documents using AGREE II and RIGHT tools. Inter-rater reliability was assessed via ICC; subgroup analyses examined document type, methodology, developer number, and region. The systematic review protocol was registered with PROSPERO (CRD420261415315).

Among 33 included documents (17 CPGs, 16 ECSs), AGREE II scores varied substantially, highest in "Scope and Purpose" (58.42%) and lowest in "Applicability" (32.35%). RIGHT assessment showed sufficient basic reporting but critical gaps in evidence summaries, benefit-harm analyses, and update plans. Guidelines, evidence-based documents, and those with ≥50 developers scored higher. International guidelines outperformed Chinese ones in all quality domains (ICCs > 0.75).

Current CHD guidance documents are purposeful but deficient in rigor, applicability, and transparency. Chinese guidelines lag behind international standards. Future development must adopt evidence-based methods, emphasize applicability, mandate patient and family engagement and improve reporting to effectively translate evidence into practice.

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261415315, PROSPERO CRD420261415315.