GAP I aimed to assess the quality of clinical practice guidelines in Surgery and to identify factors associated with quality.
We performed a scoping review of PubMed and Google Scholar and a formal search of MEDLINE through PubMed to identify guidelines published by major national and surgical organizations with an international scope. Guidelines published from January 2008 to August 2017 were eligible for inclusion.
We selected 35 scientific organizations in General Surgery across upper gastrointestinal, bariatric, colo-rectal, hernia and abdominal wall, endoscopic and minimally invasive, acute and emergency surgery.
Ten surgical organizations produced 67 guidelines over the period 2008 to 2017. Two independent reviewers independently assessed the quality against AGREE II criteria with high inter-rater agreement (median kappa, 0.799; interquartile range, 0.738–0.879).
The median overall score across all 67 guidelines was 4 out of a maximum of 7 (IQR 3 – 5), whereas 27 (40%) guidelines were not considered suitable for use based on their quality as assessed using the AGREE II instrument.