Quality and utilization of the Finnish clinical practice guideline in schizophrenia: evaluation using AGREE II and the vignette approach

Figures & data

Table 1 Main definition of domains in the AGREE II instrument

AGREE II domain^Citation21	Definition of items
Scope and Purpose	The overall objective of the guideline, health questions, and target population
Stakeholder Involvement	Development process and target users of the guideline
Rigor of Development	Systematic literature search methods, evidence of selection criteria, strengths and limitations of the evidence, formulation of recommendations, consideration of benefits and harms, link between recommendations and evidence, external review, and documented updating strategy
Clarity and Presentation	Specific and unambiguous recommendations, management options, and clearly presented key recommendations
Applicability	Facilitators and barriers to application, advice or tool, and resource for implementation and monitoring and/or auditing criteria
Editorial Independence	Funding body and competing interests

Abbreviation: AGREE II, Appraisal of Guidelines for Research and Evaluation II.

Table 2 Evaluation of the utilization of the Schizophrenia Guideline with a vignette

The vignette questions	Number of recommendations	Key recommendations according to the guideline
Where would the treatment take place?	1	Outpatient care
What would the treatment include?	2	Long-term, confidential treatment relationship
	3	Care/rehabilitation plan
	4	Antipsychotic medication
	5	Specific forms of psychosocial individual care
	6	Psychoeducation for family
	7	Psychosocial rehabilitation
	8	Promoting occupational rehabilitation and supported employment

Note: Schizophrenia Guideline, Finnish Current Care Schizophrenia Guideline.

Table 3 AGREE II domains and quality evaluation of the Current Care Schizophrenia Guideline

AGREE II domain^Citation21	Mean score in %
Scope and Purpose	77
Stakeholder Involvement	51
Rigor of Development	56
Clarity of Presentation	69
Applicability	50
Editorial Independence	42

Abbreviation: AGREE II, Appraisal of Guidelines for Research and Evaluation II.

Table 4 The results after recategorizing the vignette answers

End result	Total (n=49)	%
In agreement (n)	9	18
Minor variation (n)	19	39
Major variation (n)	20	41
No statement (n)	1	2

Notes: A number of recommendations recognized.⁶¹ Scoring range: 8 = “In agreement”; 5–7 = “Minor variations”; 1–4 = “Major variations”; and 0 = “No statement”.

Table 5 The guideline’s key recommendations and the participants’ answers

The recommendations related to questions presented	Yes, n (%)	No, n (%)
1. Outpatient care	39 (80)	10 (20)
2. Treatment relationship	19 (39)	30 (61)
3. Care plan	28 (57)	21 (43)
4. Medication	41 (84)	8 (16)
5. Psychosocial individual care	23 (47)	26 (53)
6. Family psychoeducation	36 (73)	13 (27)
7. Psychosocial rehabilitation	40 (82)	9 (18)
8. Occupational rehabilitation	19 (39)	30 (61)

BrouwersMKhoMEBrowmanGPAGREE II: advancing guideline development, reporting and evaluation in healthcareCMAJ201018218E839E84210.1503/cmaj.09205320603348

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