Evaluation of fetal growth restriction guidelines Based on AGREE II, STAR and RIGHT Tools

Objectives To comprehensively evaluate the quality of guidelines related to fetal growth restriction(FGR), with a view to provide recommendations for the development of high-quality guidelines. Methods CNKI, Wanfang, Chinese Medical journal, PubMed, Embase, Web of Science and other databases were searched for FGR guidelines published from database establishment to September, 2024. Used the Appraisal of Guidelines for Research and Evaluation II(AGREEII)instrument, the Reporting Items for practice Guidelines in Health care (RIGHT) checklist and Scientific, Transparent and Applicable Rankings (STAR) tool to assess the quality of guidelines. We tested the consistency of the evaluation results of researchers by calculating the intraclass correlation coefficient (ICC). Results A total of 10 guidelines were included in this study, including nine English CPGs and one Chinese CPG. According to the AGREE II instrument, two CPGs were “recommended,” while eight were “suggested with modifications”. STAR tool results showed scores of 0.00%, 0.00%, 26.41%, 18.49%, 38.28%, 55.85%, 62.55%, 26.54%, 88.66%, 27.54%, and 70.00% for registry, protocol, funding, guideline development groups, conflicts of interest, clinical questions, evidence, consensus method, recommendations, accessibility, and other aspects, respectively. RIGHT checklist reporting rates were 76.67% (basic information), 66.25% (background), 68.00% (evidence), 68.57% (recommendations), 70.00% (review and quality assurance), 40.00% (funding and declaration and management of interests), and 73.34% (other information). Conclusions The quality of FGR guidelines still needs to be further improved. It is recommended that future guideline development and updates should pay more attention to clarifying the target populations and settings of guideline use. Guideline authors should involve experts in statistics and guideline methodology to enhance the quality of evidence supporting the guidelines. Additionally, the influencing factors during guideline dissemination to clinical practice, as well as the practical implementation of guidelines in clinical settings, should be considered more comprehensively. Furthermore, the independence of guideline development, including the management of conflicts of interest and funding issues, also requires improvement.