Quality Assessment of Clinical Practice Guideline Providing Recommendations for Oral Cancer: A Systematic Survey

Abstract

The aim of this systematic survey was to evaluate the quality of clinical practice guidelines (CPGs) that provide recommendations for the detection, diagnosis, and treatment of oral cavity cancer (OCC). We conducted a systematic search in MEDLINE, EMBASE, Epistemonikos, CPG websites, and scientific societies to identify documents providing recommendations for the detection, diagnosis, and treatment of OCC. Two reviewers independently assessed the included CPGs using the AGREE II instrument. We calculated standardized scores for the six domains and provided a final recommendation for each CPG. We identified twenty-five CPGs published between 2019 and 2024. The mean scores (higher scores indicate better domain assessment) per domain were as follows: scope and purpose, 80.5 ± 11.6%; stakeholder involvement, 55.6 ± 16.7%; rigor of development, 48.3 ± 20.1%; clarity of presentation, 83.8 ± 8.2%; applicability, 33.6 ± 19.1%; and editorial independence, 57.3 ± 22.4%. The overall mean rate was 4.8 ± 0.8, with a maximum score of seven. Reviewers recommended five guidelines for use in practice, twelve were recommended with modifications, and eight were not recommended. The overall quality of CPGs on OCC was suboptimal. CPG developers should strengthen the use of systematic, transparent methodologies and frameworks for evidence synthesis and recommendation formulation, thereby improving the quality of recommendations and facilitating implementation across diverse clinical contexts.