Guidelines for the use of biomarkers: Principles, processes and practical considerations

Figures & data

Figure 1. Phases of biomarker evaluation.

Table I. Overview of publications investigating the quality of guidelines with the AGREE Instrument [7]. Figures in brackets represent 95% confidence intervals.

				AGREE SCORES (%)
Reference	Publication date of guidelines included in the review	Origin of guidelines	Number of guide-lines	Domain 1 Scope and purpose	Domain 2 Stakeholder involvement	Domain 3 Rigour of development	Domain 4 Clarity and presentation	Domain 5 Applicability	Domain 6 Editorial independence
Horvath et al, 2007 [6]	2003-2007	Mainly from Europe and North America	712 ^*	65	34	34	63	26	30
Alonso-Coello et al, 2009 [7]**	2003-2008	42% Europe 41% North America 17% Other	626	64 (61.9-66.4)	35 (33.9-37.5)	43 (41.0-45.2)	60 (57.9-61.9)	22 (20.4-23.9)	30 (27.9-32.3)

*Figure includes unpublished assessment of 189 national guidelines and care pathway protocols retrieved from the “ grey literature ”.

**Personal communication by authors.

Figure 2. The process of guideline adaptation [24].

Figure 3. The process of de novo guideline development.

Alonso-Coello P, Irfan AB, Sola I, Gich I, Delgado-Noguera M, Rigau D, Tort S, Bonfill X, Burgers JS, Schunemann HS. The quality of clinical practice guidelines has improved over the last two decades: a systematic review of guideline appraisal studies (submitted).

 Google Scholar

Horvath AR, Nagy E, Watine J. Critical appraisal of guidelines. Price CP, Christenson RH. Evidence-based laboratory medicine: From principles to practice. AACC Press, Washington. 2nd, 2007. 295–319.

 Google Scholar

Fervers B, Burgers JS, Haugh M, Latreille J, Mlika-Cabanne N, Paquet L, Coulombe M, Poirier M, Burnand B, for the ADAPTE working group. Adaptation of clinical guidelines: A review of methods and experiences. Int J Qual Health Care 2006;18:167–76. The ADAPTE manual is freely available now on http://www.g-i-n.net/activities/adaptation-working-group (Accessed 2010-05-13).

 Google Scholar