A critical appraisal of the quality of adult musculoskeletal ultrasound guidelines using the AGREE II tool: an EuroAIM initiative

Carmelo Messina, Bianca Bignotti, Alberto Tagliafico, Davide Orlandi, Angelo Corazza, Francesco Sardanelli, Luca Maria Sconfienza

Our aim was to evaluate the quality of published guidelines on musculoskeletal ultrasound (MSK-US) for adults. Between June and July 2016, we conducted an online search for MSK-US guidelines, which were evaluated by four independent readers blinded to each other using the AGREE II tool. A fifth independent reviewer calculated scores per each domain and agreement between reviewers' scores using the intraclass correlation coefficient (ICC). Five guidelines were included in this appraisal. They were published between 2001 and 2014. Our appraisal showed intermediate results, with four out of five guidelines scoring "average" as overall quality. Domain 1 (scope and purpose) achieved the highest result (total score = 71.1% ± 18.7%). Domain 6 (editorial independence) had the lowest score (total score = 26.3% ± 19.3%). Interobserver agreement was very good for all the evaluated guidelines (ICC ranged between 0.932 and 0.956). Overall, quality of MSK-US guidelines ranges from low to average when evaluated using the AGREE II tool. The editorial independence domain was the most critical, thus deserving more attention when developing future guidelines. • Four of five guidelines on MSK-US had an average quality level. • Scope/purpose had the highest score (71.1% ± 18.7%). • Editorial independence had the lowest score (26.3% ± 19.3%). • Interobserver agreement was very good (ranges: 0.932-0.956).