Systematic appraisal of Chilean clinical guidelines included in the 'Explicit Guarantees in Healthcare' Program using AGREE II




Poster session 3 Friday: Evidence Tools / Evidence synthesis - creation, publication and updating in the digital age


Friday 15 September 2017 - 12:30 to 14:00


All authors in correct order:

Loézar Hernández C1, Pérez-Bracchiglione J1, Vargas Peirano M1, Papuzinski C1, Ondarza C2, Jahr C3, Meza N3, Arancibia M1, Madrid E1, Cadena C4
1 Cochrane Centre - Universidad de Valparaiso, Chile
2 Universidad de Valparaiso, Chile
3 School of Medicine - Universidad de Valparaiso, Chile
4 Department of Gynaecology - Universidad de Valparaiso, Chile
Presenting author and contact person

Presenting author:

Cristobal Loezar Hernandez

Contact person:

Abstract text
Background: During 2005, Chilean Health reform mandated that all healthcare providers should ensure assistance for 25 health conditions under a guaranteed system. Currently, 86 clinical practice guidelines (CPGs) addressing 80 health problems are included in the 'Explicit Guarantees in Healthcare' programme (EGH). The Health Ministry has developed CPGs, but the quality has been scarcely appraised by independent assessors so far.

Objectives: To asses quality of Chilean CPGs included in the EGH programme using the AGREE II instrument.

Methods: Four blinded reviewers assessed the CPGs using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. Additionally, we appraised the validity period, last update and area (screening, diagnosis, treatment, rehabilitation).

Results: 86 CPGs were published between 2005 and 2016. Fifteen (17.4%) were updated at the declared period, 62 (72.1%) were out-dated, and 9 (10.5%) were undetermined. The overall mean score was 4.18 (±0.98). The scaled scores by domain (fig 2) were: domain 1 (scope and objectives) 79.7%; domain 2 (stakeholder involvement) 46.2%; domain 3 (rigour of development) 36.3%; domain 4 (clarity of presentation) 82.8%; domain 5 (applicability) 23.5%; domain 6 (editorial independence) 39.2% (fig 1). The items with the highest scaled score (≥80% of the maximum) were related to overall objectives specifically described, population specifically described, different options for management clearly presented, and key recommendations easily identifiable (table 1). The worst evaluated items (≤20% of the maximum) were: the views and preferences of the target population, strengths and limitations of the body of evidence, methods for formulating the recommendations, external review by experts, description of facilitators and barriers to application, and potential resource implications of applying the recommendations (Table 1).

Conclusions: Most Chilean CPGs included in the EGH programme are out-dated and show many items that should be improved mainly through a more rigorous methodology, the inclusion of patients in its development, and the appropriate consideration of its applicability.