Quantity and Quality of Rheumatoid Arthritis and Osteoarthritis Clinical Practice Guidelines: Systematic Review and Assessment Using AGREE II

ObjectivesThe purpose of this study was to identify the quantity and evaluate the quality of clinical practice guidelines for the treatment and/or management of rheumatoid arthritis (RA) and osteoarthritis (OA).MethodsWe conducted a systematic review, searching MEDLINE, EMBASE and CINAHL databases from 2008 to 2018. The Guidelines International Network website was also searched. Eligible guidelines were assessed using the AGREE II instrument.ResultsFrom 525 unique search results, 12 RA guidelines and 3 OA CPGs were found to be eligible. Scaled domain percentages from highest to lowest were clarity of presentation (89.8%), scope and purpose (88.0%), stakeholder involvement (67.6%), rigour of development (62.2%), editorial independence (56.4%) and applicability (53.3%). Quality varied within and across guidelines. None of the 15 guidelines were recommended by both appraisers; 11 were recommended as Yes or Yes with modifications.ConclusionsA number of guidelines for the treatment and/or management of RA or OA are available to support informed decision-making among healthcare practitioners and patients. CPGs were of variable quality; those that received lower scaled domain percentages or overall recommendations could be improved by using the AGREE II instrument, or insight from tools that are available to support guideline development and implementation.