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Hum. Reprod. Advance Access published online on May 13, 2008

Human Reproduction, doi:10.1093/humrep/den120
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The methodological quality of clinical guidelines of the European Society of Human Reproduction and Embryology (ESHRE)

W.L.D.M. Nelen1,6, R.W. van der Pluijm1, R.P.M.G. Hermens2, C. Bergh3, P. de Sutter4, K.G. Nygren5, A.M.M. Wetzels1, R.P.T.M. Grol2 and J.A.M. Kremer1

1 Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands 2 Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands 3 Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Sweden 4 Infertility Centre, Ghent University Hospital, Ghent, Belgium 5 IVF Unit, Sophiahemmet, Stockholm, Sweden

6 Correspondence address. E-mail: w.nelen{at}obgyn.umcn.nl

BACKGROUND: Clinical practice guidelines bridge the gap between the evidence from literature and clinical practice, and they may provide guidance in ethical, legal and societal dilemmas. To explore the potentials for future international guideline development within the field of human reproduction and embryology, we assessed the quality of existing guidelines produced by the European Society of Human Reproduction and Embryology (ESHRE).

METHODS: We systematically searched for the ESHRE guidelines produced after 1996 in electronic databases and on the Internet. Subsequently, we assessed the methodological quality of these guidelines using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument.

RESULTS: The overall methodological quality of most of the 11 selected ESHRE guidelines was poor. Most of the guidelines scored <30% in the domains of ‘stakeholder involvement’, ‘rigour of development’, ‘applicability’ and ‘editorial independence’. Only one guideline was rated ‘strongly recommended’.

CONCLUSIONS: The methodological quality of the guidelines produced under the auspices of ESHRE can be improved. We suggest a systematic, up-to-date methodology, investment in guideline development specialists, systematic quality control and the incorporation of indicator development. Furthermore, attention should be paid to the document nomenclature, and an ESHRE guidelines’ summary on a special part of the ESHRE website would be a good initiative.

Key words: guideline/quality of care/subfertility/ESHRE

Submitted on November 27, 2007; resubmitted on March 11, 2008; accepted on March 20, 2008.


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