A critical appraisal of guidelines and recommendations for the management of ANCA-associated vasculitis.
11 affiliations
- 1Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- 2Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Zagreb, Croatia.
- 3Faculty of Health Studies, University of Rijeka, Rijeka, Croatia.
- 4Yonsei University College of Medicine, Seoul, Republic of Korea.
- 5Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK.
- 6Department of Renal Medicine, Karolinska University Hospital and CLINTEC Karolinska Institutet, Stockholm, Sweden.
- 7Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria.
- 8Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
- 9The Center for Medical Education Training and Professional Development in Yonsei-Donggok Medical Education Institute, Seoul, Korea.
- 10Severance Underwood Meta-research Center, Institute of Convergence Science, Yonsei University, Seoul, Korea.
- 11Section of Digestive Diseases, Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
Abstract
Objectives
We aimed to appraise 11 currently available guidelines for ANCA-associated vasculitis (AAV), identify potential gaps, and provide recommendations for improvement.Methods
The guidelines were appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument consisting of 23 appraisal criteria/items across six domains (D). Four reviewers independently appraised guidelines and scaled domain scores were calculated.Results
The average score of all guidelines was 4.5 ± 0.8 out of 7.0. Agreement between the reviewers was excellent. British Society for Rheumatology 2025 guidelines scored highest (5.8/7.0), being the only guideline unanimously recommended for use. In 'D1/Scope and purpose', all guidelines achieved high scores. In 'D2/Stakeholder involvement', major gaps were identified in the inclusion of the views and preferences of the target population (2c), with few guidelines including patient representatives, addressing patient participation, or considering patient views. In 'D3/Rigour of development', all but two guidelines received high scores. Implementation of the procedure for updating the guidelines (3 h) and for external review (3 g) was addressed poorly. In 'D4/Clarity of presentation', all guidelines except one received a high score. 'D5/Applicability' had the lowest scores due to gaps in the criteria for monitoring/auditing guideline implementation (5d), resource/cost implications (5c), lack of advice/tools for implementation (5a), and inadequate addressing of facilitators/barriers in guideline application (5a). 'D6/Editorial independence' was addressed well.Conclusions
Several aspects of AAV guidelines could be improved, including the inclusion of patient views and preferences, the processes for translating guidelines into clinical practice, and clearer criteria for monitoring guideline implementation and uptake.
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BibTeX
@article{ivkovic2026critical,
title = {{A critical appraisal of guidelines and recommendations for the management of ANCA-associated vasculitis.}},
author = {Vanja Ivković and Sejin Park and Lauren Floyd and Yoon Seo Kwon and Annette Bruchfeld and Andreas Kronbichler and Jae Il Shin},
journal = {Clinical kidney journal},
year = {2026},
month = oct,
doi = {10.1093/ckj/sfag317},
url = {https://europepmc.org/article/MED/42909277},
note = {CC BY},
}
RIS
TY - JOUR
TI - A critical appraisal of guidelines and recommendations for the management of ANCA-associated vasculitis.
AU - Vanja Ivković
AU - Sejin Park
AU - Lauren Floyd
AU - Yoon Seo Kwon
AU - Annette Bruchfeld
AU - Andreas Kronbichler
AU - Jae Il Shin
PY - 2026
DA - 2026/10/09
JO - Clinical kidney journal
DO - 10.1093/ckj/sfag317
UR - https://europepmc.org/article/MED/42909277
AB - Objectives We aimed to appraise 11 currently available guidelines for ANCA-associated vasculitis (AAV), identify potential gaps, and provide recommendations for improvement.Methods The guidelines were appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument consisting of 23 appraisal criteria/items across six domains (D). Four reviewers independently appraised guidelines and scaled domain scores were calculated.Results The average score of all guidelines was 4.5 ± 0.8 out of 7.0. Agreement between the reviewers was excellent. British Society for Rheumatology 2025 guidelines scored highest (5.8/7.0), being the only guideline unanimously recommended for use. In 'D1/Scope and purpose', all guidelines achieved high scores. In 'D2/Stakeholder involvement', major gaps were identified in the inclusion of the views and preferences of the target population (2c), with few guidelines including patient representatives, addressing patient participation, or considering patient views. In 'D3/Rigour of development', all but two guidelines received high scores. Implementation of the procedure for updating the guidelines (3 h) and for external review (3 g) was addressed poorly. In 'D4/Clarity of presentation', all guidelines except one received a high score. 'D5/Applicability' had the lowest scores due to gaps in the criteria for monitoring/auditing guideline implementation (5d), resource/cost implications (5c), lack of advice/tools for implementation (5a), and inadequate addressing of facilitators/barriers in guideline application (5a). 'D6/Editorial independence' was addressed well.Conclusions Several aspects of AAV guidelines could be improved, including the inclusion of patient views and preferences, the processes for translating guidelines into clinical practice, and clearer criteria for monitoring guideline implementation and uptake.
SN - 2048-8505
SN - 2048-8513
ER -