A critical evaluation of a clinical practice guideline for the management of head and neck cancer, using the AGREE II tool
DOI:
https://doi.org/10.16921/pfr.v10i3.389Keywords:
clinical practice guidelines, head and neck neoplasms, AGREE II, evidence-based medicineAbstract
Introduction: Clinical practice guidelines (CPGs) play a crucial role in standardizing medical and oncological care to improve patient outcomes. The National Comprehensive Cancer Network (NCCN) guidelines are widely used worldwide in cancer care. However, systematic evaluation of their methodological quality using validated instruments remains limited. Objective: This study aimed to critically evaluate the methodological quality of the NCCN Clinical Practice Guideline for head and neck cancers (version 5.2025) using the AGREE II instrument. Methods: A systematic evaluation was performed using the AGREE II instrument, which covers six domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence. Each of the 23 items was rated on a 7-point Likert scale and analyzed using an Excel-based data matrix. Results: The CPG demonstrated high overall methodological quality, achieving an average score of 83.3% (SD: 5.1%). Scores by domain ranged from excellent for clarity of presentation (97.5%, SD: 5.0%) and editorial independence (92.5%, SD: 15.0%), to acceptable for applicability (62.5%, SD: 12.3%). The scope and purpose (92.1%, SD: 6.5%) and the rigor of development (77.8%, SD: 12.8%) performed well. However, stakeholder involvement (77.2%, SD: 8.7%) revealed opportunities for improvement in future updates. Conclusions: The NCCN CPG on head and neck cancer demonstrates high methodological quality across multiple evaluation dimensions. The clinical use of the recommendations with contextual adaptations is recommended, particularly regarding resource considerations and local barriers to implementation.
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