The Guideline Assessment Project is a tripartite project that aims to develop an evidence-based and consensus-informed AGREE II Extension for Surgical Guidelines.


The third part of the project aims to use the information from the previous GAP projects to develop the extension document using a structured Delphi process involving relevant stakeholders.

The executive group consists of surgeons, members of surgical quality and research boards, guideline developers, evidence synthesis experts, GRADE methodologists, biostatisticians, and 2 leads of the AGREE Group.

It is further divided into 4 working groups with distinct functions and responsibilities:

  • The strategic steering group is responsible for overseeing the project.

  • The methods group coordinates the methodology of the project.

  • The evidence review group will review the literature for evidence on candidate new items to be included in the extension document.

  • The evidence synopsis group will summarize evidence for presentation to Delphi participants.

The executive group attended a one-day meeting to discuss the findings of previous work, define the methodology and study design, and identify potential stakeholder groups to comprise the Delphi panel.

Delphi process

The Delphi panel will consist of key stakeholders, including; representatives from different surgical disciplines, guideline developers from different continents and representatives of guideline development organizations. The public will be involved by participation of patient representatives from the European Patients Forum. We will develop a web-based survey tool to facilitate Delphi exercises. Findings of previous work (GAP I and GAP II) and further evidence that will be identified through a scoping literature review will be summarized and presented to Delphi participants. Online links to full documents for detailed review of the evidence will be provided.