Appraisal of clinical practice guidelines for salivary gland cancer management utilizing AGREE II instrument

Objective: Salivary gland cancers (SGC) are rare neoplasms which comprise 1–5 % of all head and neck cancers. SGCs can be managed by resection, radiosurgery, chemotherapy, or a combination of these. Our team appraised the quality of clinical practice guidelines (CPGs) for SGC treatment and management using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. Data sources: PubMed, Scopus, & EMBASE were reviewed for CPGs regarding SGC management from database inception to January 1st, 2023. Review methods: The AGREE-II instrument was used by 4 reviewers to independently evaluate guidelines. Domain scores were generated with a satisfactory threshold being >60 % — a “high” quality CPG required >4 satisfactory domains. Intraclass correlation coefficients (ICCs) were used, via R 4.2.1., to determine inter-reviewer variability. Results: Literature review identified 645 articles, with six being included after applying inclusion and exclusion criteria. Of the six included articles, one CPG was “high” quality and 5 were “low” quality. The domains with the highest scores were “Editorial Independence” (72.57 ± 36.60) and “Clarity and Presentation” (63.19 ± 26.08), while the lowest were “Rigor of Development” (34.03 ± 30.63) and “Applicability” (30.21 ± 30.46). ICC scores for each domain ranged from 0.937 to 0.983, indicating a high level of inter-rater agreement. Conclusion: This study found that most CPGs for the treatment and management of SGC were of “low” quality, with only one guideline being considered “high” quality based on the standard set by the AGREE-II instrument. These findings indicate that there is a high level of variability and little standardization when it comes to the quality of CPGs.