Quality assessment of clinical practice guidelines on treatments for oral cancer

Background: The applicability of clinical practice guidelines (CPGs) on treatments for oral cancer remains unknown since there are no systematic assessments of their quality. Thus, the objective of this study is to identify and assess the quality of them. Methods: We conducted a systematic search to identify CPGs that provided recommendations on treatments for oral cancer. The quality of each included CPG was determined using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, by four appraisers independently. The inter-appraisers agreement was assessed. Results: Twelve CPGs met the eligibility criteria. Overall agreement among appraisers was very good (ICC: 0.865; 95% CI: 0.835-0.889). The mean scores for each AGREE domain were the following: "scope and purpose" 88.4% +/- 12.4%; "stakeholder involvement" 60.4% +/- 25%; "rigor of development" 60.9% +/- 25.3%; "clarity of presentation" 76.5% +/- 19.8%; "applicability" 32.2% +/- 30.7%; and "editorial independence" 61.6% +/- 35.5%. Three CPGs were rated as "recommended"; six as "recommended with modifications"; and three as "not recommended". Conclusions: Overall, the quality of CPGs on treatments for oral cancer is suboptimal. These findings highlight the need to improve CPG development processes and their applicability in this field. Thus, increased efforts are required to enable the development of high-quality evidence-based CPGs for oral cancer.