Table 2: Evaluation of 17* guidelines by 2 reviewers using a checklist
Guideline evaluation criteria	Yes	No	Disagreement
Context
Was the rationale for the guideline stated?	14	2	0
Were all appropriate health care professionals involved in guideline formulation?†	9	3	1
Methods, general
How were the methods for guideline development described?
1. Fully described and reproducible?	0	16	0
2. Refer to a process but insufficient detail to reproduce?	7	9	0
3. No method was described?	9	7	0
Was a target patient population specified?	8	5	3
Were all relevant outcomes identified (e.g., mortality, morbidity, quality of life)?	2	12	2
Were alternative interventions identified?	11	5	0
Does the guideline include a definition of the intervention and its optimal role in patient management?	6	10	0
Search strategy Was a computer search conducted?	2	14	0
Was a manual search of references from relevant articles conducted?	2	14	0
Is the search strategy reproducible?	0	16	0
Literature selection Were reasons for inclusion of literature explicitly stated?	1	15	0
Were reasons for exclusion of literature explicitly stated?	0	16	0
Data synthesis
Was an attempt made to evaluate the strength of evidence? (i.e., Did the authors distinguish between randomized, controlled trials and animal studies?)	1	15	0
If so, was a system of evidence evaluation determined?	1	14	1
Recommendations
Was the process of recommendation formulation specified?	2	14	0
Does each recommendation cite specific evidence bearing upon the conclusion?	9	7	0
Are each of the recommendations appropriate given the strength of the evidence?†	3	4	0
Does the guideline explicitly state the strength of the recommendation?	2	14	0
Guidelines
Are all of the recommendations in the document consistent with each other?	13	2	1
Do the guidelines provide the option of choice for the patient, if appropriate?	3	13	0
Have the guidelines been peer reviewed?	12	4	0
Have the guidelines been pilot tested?	0	16	0
Is there a stated plan for revisions or renewal?	0	16	0
Has the effectiveness of the guidelines been evaluated?	0	16	0
Note: "Guidelines" refers to the entire document; "recommendations" refers to the individual statements in the document. *Two guidelines80,81 were treated as 1 as they were virtually identical. †There was insufficient information provided to answer this question in the remaining guidelines.

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