Quality appraisal and consistency test
The quality of included guidelines was evaluated by two investigators using AGREE II instrument, with the assistance of the third investigator in case of disagreement. AGREE II is currently the most widely used and extensive tool for evaluating guidelines.20 23 items are evaluated in six domains of Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability, Editorial Independence, and two overall evaluations items. Each item is graded on a seven-point scale, one point means strongly disagree, and seven-point means strongly agree, one to seven points are given based on whether the guidelines report meets the criteria or conditions for the entry, and the distribution of points depends on the completeness and quality of the report. After completing the evaluation of each entry, the quality score of each domain was calculated separately, calculated as = (actual score for the domain - lowest possible score) / (highest possible score - lowest possible score) × 100%, which means the higher the standardized percentage score for each domain, the higher the quality of the guideline. Guidelines are rated based on standardized percentage scores in six domains, and if the total standardized score of each field is ≥ 60%, it is recommended for the A level. If the number of fields with standardized total scores is ≥ 30% over 3, but there are fields with scores < 60%, it is recommended for B level. If the number of fields with a standardized total score < 30% over 3 is recommended for the C level.
ICC was used for the consistency test according to the results of the evaluation according to the researcher’s guidelines. ICC ≥ 0.75 indicated high consistency.