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.