The quality of reporting practice guidelines is often poor, and there is no widely accepted guidance or standards for such reporting in health care. The international RIGHT (Reporting Items for practice Guidelines in HealThcare) Working Group was established to address this gap. The group followed an existing framework for developing guidelines for health research reporting and the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach. It developed a checklist and an explanation and elaboration statement. The RIGHT checklist includes 22 items that are considered essential for good reporting of practice guidelines: basic information (items 1 to 4), background (items 5 to 9), evidence (items 10 to 12), recommendations (items 13 to 15), review and quality assurance (items 16 and 17), funding and declaration and management of interests (items 18 and 19), and other information (items 20 to 22). The RIGHT checklist can assist developers in reporting guidelines, support journal editors and peer reviewers when considering guideline reports, and help health care practitioners understand and implement a guideline.
References
- 1.
Oxman AD ,Schünemann HJ ,Fretheim A . Improving the use of research evidence in guideline development: 14. Reporting guidelines. Health Res Policy Syst. 2006;4:26. [PMID:17156458 ] CrossrefMedlineGoogle Scholar - 2.
Grilli R ,Magrini N ,Penna A ,Mura G ,Liberati A . Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet. 2000;355:103-6. [PMID:10675167 ] CrossrefMedlineGoogle Scholar - 3.
Shiffman RN ,Shekelle P ,Overhage JM ,Slutsky J ,Grimshaw J ,Deshpande AM . Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline Standardization. Ann Intern Med. 2003;139:493-8. [PMID:13679327 ] LinkGoogle Scholar - 4.
Oxman AD ,Schünemann HJ ,Fretheim A . Improving the use of research evidence in guideline development: 16. Evaluation. Health Res Policy Syst. 2006;4:28. [PMID:17156460 ] CrossrefMedlineGoogle Scholar - 5.
Wilson KC ,Irwin RS ,File TM ,Schünemann HJ ,Guyatt GH ,Rabe KF ;ATS/ERS Ad Hoc Committee on Integrating and Coordinating Efforts in COPD Guideline Development . Reporting and publishing guidelines: article 12 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:293-7. [PMID:23256173 ] doi:10.1513/pats.201208-065ST CrossrefMedlineGoogle Scholar - 6.
Huwiler-Müntener K ,Jüni P ,Junker C ,Egger M . Quality of reporting of randomized trials as a measure of methodologic quality. JAMA. 2002;287:2801-4. [PMID:12038917 ] CrossrefMedlineGoogle Scholar - 7.
Brouwers MC ,Kho ME ,Browman GP ,Burgers JS ,Cluzeau F ,Feder G ,et al ;AGREE Next Steps Consortium . AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010;182:E839-42. [PMID:20603348 ] doi:10.1503/cmaj.090449 CrossrefMedlineGoogle Scholar - 8.
Brouwers MC ,Kerkvliet K ,Spithoff K ;AGREE Next Steps Consortium . The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines. BMJ. 2016;352:i1152. [PMID:26957104 ] doi:10.1136/bmj.i1152 CrossrefMedlineGoogle Scholar - 9.
Moher D ,Schulz KF ,Simera I ,Altman DG . Guidance for developers of health research reporting guidelines. PLoS Med. 2010;7:e1000217. [PMID:20169112 ] doi:10.1371/journal.pmed.1000217 CrossrefMedlineGoogle Scholar - 10. EQUATOR Network. Reporting items for guidelines in health systems. 2014. Accessed at www.equator-network.org/library/reporting-guidelines-under-development on 9 July 2015. Google Scholar
- 11. EQUATOR Network. Reporting guidelines for main study types. 2014. Accessed at www.equator-network.org/library on 9 July 2015. Google Scholar
- 12.
Chan AW ,Tetzlaff JM ,Altman DG ,Laupacis A ,Gøtzsche PC ,Krleža-Jerić K ,et al . SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200-7. [PMID:23295957 ]. doi:10.7326/0003-4819-158-3-201302050-00583 LinkGoogle Scholar - 13.
Moher D ,Liberati A ,Tetzlaff J ,Altman DG ;PRISMA Group . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264-9. [PMID:19622511 ] LinkGoogle Scholar - 14.
Gagnier JJ ,Kienle G ,Altman DG ,Moher D ,Sox H ,Riley D ;CARE Group . The CARE guidelines: consensus-based clinical case report guideline development. J Clin Epidemiol. 2014;67:46-51. [PMID:24035173 ] doi:10.1016/j.jclinepi.2013.08.003 CrossrefMedlineGoogle Scholar - 15.
Schulz KF ,Altman DG ,Moher D ;CONSORT Group . CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Ann Intern Med. 2010;152:726-32. [PMID:20335313 ]. doi:10.7326/0003-4819-152-11-201006010-00232 LinkGoogle Scholar - 16.
von Elm E ,Altman DG ,Egger M ,Pocock SJ ,Gøtzsche PC ,Vandenbroucke JP ;STROBE Initiative . Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573-7. [PMID:17938396 ] LinkGoogle Scholar - 17.
Tong A ,Sainsbury P ,Craig J . Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349-57. [PMID:17872937 ] CrossrefMedlineGoogle Scholar - 18.
Bossuyt PM ,Reitsma JB ,Bruns DE ,Gatsonis CA ,Glasziou PP ,Irwig LM ,et al ;Standards for Reporting of Diagnostic Accuracy . Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. Ann Intern Med. 2003;138:40-4. [PMID:12513043 ] LinkGoogle Scholar - 19.
Davidoff F ,Batalden P ,Stevens D ,Ogrinc G ,Mooney SE ;SQUIRE development group . Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project. BMJ. 2009;338:a3152. [PMID:19153129 ] doi:10.1136/bmj.a3152 CrossrefMedlineGoogle Scholar - 20.
Husereau D ,Drummond M ,Petrou S ,Carswell C ,Moher D ,Greenberg D ,et al ;CHEERS Task Force . Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. BMJ. 2013;346:f1049. [PMID:23529982 ] doi:10.1136/bmj.f1049 CrossrefMedlineGoogle Scholar - 21.
Kilkenny C ,Browne WJ ,Cuthill IC ,Emerson M ,Altman DG . Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. J Pharmacol Pharmacother. 2010;1:94-9. [PMID:21350617 ] doi:10.4103/0976-500X.72351 CrossrefMedlineGoogle Scholar - 22. RIGHT Statement. About RIGHT. 2014. Accessed at www.right-statement.org on 9 July 2015. Google Scholar
- 23.
Murphy MK ,Black NA ,Lamping DL ,McKee CM ,Sanderson CF ,Askham J ,et al . Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2:1-88. [PMID:9561895 ] CrossrefMedlineGoogle Scholar - 24.
Sinha IP ,Smyth RL ,Williamson PR . Using the Delphi technique to determine which outcomes to measure in clinical trials: recommendations for the future based on a systematic review of existing studies. PLoS Med. 2011;8:e1000393. [PMID:21283604 ] doi:10.1371/journal.pmed.1000393 CrossrefMedlineGoogle Scholar - 25.
Greenland S ,O'Rourke K . On the bias produced by quality scores in meta-analysis, and a hierarchical view of proposed solutions. Biostatistics. 2001;2:463-71. [PMID:12933636 ] CrossrefMedlineGoogle Scholar - 26.
Jüni P ,Witschi A ,Bloch R ,Egger M . The hazards of scoring the quality of clinical trials for meta-analysis. JAMA. 1999;282:1054-60. [PMID:10493204 ] CrossrefMedlineGoogle Scholar - 27.
Brouwers MC ,Kho ME ,Browman GP ,Burgers JS ,Cluzeau F ,Feder G ,et al ;AGREE Next Steps Consortium . The Global Rating Scale complements the AGREE II in advancing the quality of practice guidelines. J Clin Epidemiol. 2012;65:526-34. [PMID:22189163 ] doi:10.1016/j.jclinepi.2011.10.008 CrossrefMedlineGoogle Scholar - 28.
Grimmer K ,Dizon JM ,Milanese S ,King E ,Beaton K ,Thorpe O ,et al . Efficient clinical evaluation of guideline quality: development and testing of a new tool. BMC Med Res Methodol. 2014;14:63. [PMID:24885893 ] doi:10.1186/1471-2288-14-63 CrossrefMedlineGoogle Scholar - 29.
Schünemann HJ ,Wiercioch W ,Etxeandia I ,Falavigna M ,Santesso N ,Mustafa R ,et al . Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise. CMAJ. 2014;186:E123-42. [PMID:24344144 ] doi:10.1503/cmaj.131237 CrossrefMedlineGoogle Scholar - 30.
Glasziou P ,Altman DG ,Bossuyt P ,Boutron I ,Clarke M ,Julious S ,et al . Reducing waste from incomplete or unusable reports of biomedical research. Lancet. 2014;383:267-76. [PMID:24411647 ] doi:10.1016/S0140-6736(13)62228-X CrossrefMedlineGoogle Scholar - 31.
Ansari S ,Rashidian A . Guidelines for guidelines: are they up to the task? A comparative assessment of clinical practice guideline development handbooks. PLoS One. 2012;7:e49864. [PMID:23189167 ] doi:10.1371/journal.pone.0049864 CrossrefMedlineGoogle Scholar - 32.
Vernooij RW ,Sanabria AJ ,Solà I ,Alonso-Coello P ,MartínezGarcía L . Guidance for updating clinical practice guidelines: a systematic review of methodological handbooks. Implement Sci. 2014;9:3. [PMID:24383701 ] doi:10.1186/1748-5908-9-3 CrossrefMedlineGoogle Scholar
Author, Article, and Disclosure Information
From Lanzhou University, Lanzhou, Gansu, China; University of Split School of Medicine, Split, Croatia; American College of Physicians, Philadelphia, Pennsylvania; Paris–Sorbonne University, Paris, France; Norwegian Institute of Public Health, Oslo, Norway; American University of Beirut, Beirut, Lebanon; McMaster University, Hamilton, Ontario, Canada; Cochrane Singapore, Biopolis, Singapore; Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio;
Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo; Taipei Medical University–School of Medicine, Taipei, Taiwan; Cochrane China, Sichuan, China; Nanjing University of Chinese Medicine, Nanjing, China; University of East Anglia, Norwich, United Kingdom; Dongzhimen Hospital of Beijing University of Chinese Medicine and Peking University, Beijing, China;
and World Health Organization, Geneva, Switzerland.
Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the World Health Organization or the Centers for Disease Control and Prevention.
Acknowledgment: The authors thank the persons who responded to the Delphi survey for their thoughtful comments.
Grant Support: By National Natural Science Foundation of China (grant 81503459; Dr. Chen), China Fundamental Research Funds for the Central Universities (grant 2016LZU-JBZX159; Dr. Chen and Prof. Yang), the Open Fund of the Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province (grant EBM1305 for the RIGHT project), and Croatian Science Foundation (grant IP-2014-09-7672; Dr. Marušić).
Disclosures: Dr. Meerpohl is a member of the GRADE Working Group and a member of the GRADE guidance committee. Dr. Flottorp is a member of the GRADE Working Group and the GRADE guidance committee. Dr. Akl is a member of the GRADE Working Group. Dr. Schünemann is the co-chair of the GRADE Working Group and the lead author of the Guidelines International Network–McMaster Guideline Development Checklist. Dr. Chan reports other part-time salary support from the Singapore Ministry of Health outside the submitted work. Dr. Falck-Ytter is a member of the GRADE Working Group. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1565.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Corresponding Author: Yaolong Chen, PhD, MMed, Lanzhou University, Donggang West Road, Chengguan District, Lanzhou, Gansu 730000, China; e-mail, [email protected]
Current Author Addresses: Drs. Y. Chen and Tian, Prof. Yang, and Ms. Wang: 199 Donggang West Road, Chengguan District, Lanzhou, Gansu 730000, China.
Dr. Marušić: Department of Research in Biomedicine and Health, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia.
Dr. Qaseem: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.
Dr. Meerpohl: Paris–Sorbonne University, 1 Rue Victor Cousin, 75230 Paris cedex 05, France.
Dr. Flottorp: Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway.
Dr. Akl: Department of Internal Medicine, American University of Beirut Medical Center, PO Box 11-0236, Riad-El-Solh, Beirut 1107 2020, Lebanon.
Dr. Schünemann: Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C161280, Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Dr. Chan: Singapore Clinical Research Institute, 31 Biopolis Way, Nanos 02-01, Singapore 138669.
Dr. Falck-Ytter: Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH 44106.
Dr. Ahmed: Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop E-03, Atlanta, GA 30329.
Dr. Barber: World Health Organization, Regional Office for Africa, Room 303, Cité du Djoué, PO Box 06, Brazzaville, Republic of Congo.
Dr. C. Chen: Taipei Medical University–School of Medicine, 250 Wuxing Street, Taipei 11031, Taiwan.
Ms. Zhang: Chinese Evidence-Based Medicine Centre, West China Hospital, 37 Guoxue Xiang, Chengdu, Sichuan 610041, China.
Dr. Xu: Nanjing University of Chinese Medicine, 43 Box, 138 Xianlin Road, Nanjing, Jiangsu 210023, China.
Dr. Song: Department of Population Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, United Kingdom.
Dr. Shang: Dongzhimen Hospital of Beijing University of Chinese Medicine, Dongcheng District, 5 Hai Yun Cang, Beijing 100700, China.
Dr. Tang: Peking University Health Science Center, 38 Xue Yuan Road, Haidian District, Beijing 100191, China.
Dr. Norris: World Health Organization, Avenue Appia 20, CH-1211, Geneva 27, Switzerland.
Author Contributions: Conception and design: Y. Chen, K. Yang, A. Qaseem, M. Zhang, B. Xu, Q. Wang, S.L. Norris.
Analysis and interpretation of the data: Y. Chen, K. Yang, J.J. Meerpohl, S. Flottorp, H.J. Schünemann, S. Barber, S.L. Norris.
Drafting of the article: Y. Chen, K. Yang, A. Qaseem, J.J. Meerpohl, E.S.Y. Chan, F. Ahmed, S.L. Norris.
Critical revision of the article for important intellectual content: Y. Chen, K. Yang, A. Marušić, A. Qaseem, J.J. Meerpohl, S. Flottorp, E.A. Akl, H.J. Schünemann, E.S.Y. Chan, Y. Falck-Ytter, F. Ahmed, S. Barber, C. Chen, M. Zhang, F. Song, S.L. Norris.
Final approval of the article: Y. Chen, K. Yang, A. Marušić, A. Qaseem, J.J. Meerpohl, S. Flottorp, E.A. Akl, H.J. Schünemann, E.S.Y. Chan, Y. Falck-Ytter, F. Ahmed, S. Barber, J. Tian, F. Song, K. Tang, Q. Wang, S.L. Norris.
Obtaining of funding: Y. Chen, K. Yang.
Administrative, technical, or logistic support: Y. Chen, K. Yang, H. Shang, K. Tang, S.L. Norris.
Collection and assembly of data: Y. Chen, K. Yang, A. Marušić, E.A. Akl, E.S.Y. Chan, Y. Falck-Ytter, F. Ahmed, C. Chen, J. Tian, Q. Wang, S.L. Norris.
This article was published at www.annals.org on 22 November 2016.
*Corresponding authors.
†Members of the RIGHT Working Group are listed in Appendix 1; their contributions are listed in Appendix 2.
Submit a Comment
Contributors must reveal any conflict of interest. Comments are moderated. Please see our information for authorsregarding comments on an Annals publication.
*All comments submitted after October 1, 2021 and selected for publication will be published online only.