PONTIFICIA UNIVERSIDAD CATÓLICA DEL

ECUADOR
MAESTRÍA DE GESTIÓN
DE CALIDAD Y SEGURIDAD DEL PACIENTE

GESTIÓN DE CALIDAD II

Utilizando el AGREE Reporting

Checklist valorar la calidad y el
reporte de la GPC asignada.

AUTORES:
jUDITH SALOME GAVILANES VALENCIA
RUTH LILIANA GUEVARA CADENA
JHON FERNANDO MAZA PATIÑO
CRISTIAN PAUL TERAN CARTAGENA

Paralelo: P1610 - TEÓRICO - PRÁCTICO - PV002 - 09 - N02

 AGREE Reporting Checklist
2016
This checklist is intended to guide the reporting of clinical practice guidelines.

Page
CHECKLIST ITEM AND DESCRIPTION REPORTING CRITERIA
#
DOMAIN 1: SCOPE AND PURPOSE
1. OBJECTIVES ¨
✔
Health intent(s) (i.e., prevention, screening,
Report the overall objective(s) of the diagnosis, treatment, etc.)
guideline. The expected health benefits ¨
✔
Expected benefit(s) or outcome(s) 3
from the guideline are to be specific to the ¨
✔
Target(s) (e.g., patient population, society)
clinical problem or health topic.
2. QUESTIONS ¨ Target population
Report the health question(s) covered by ¨
✔
Intervention(s) or exposure(s)
the guideline, particularly for the key ¨ Comparisons (if appropriate) 3-4
recommendations. ¨ Outcome(s)
¨ Health care setting or context
3. POPULATION ¨
✔
Target population, sex and age
Describe the population (i.e., patients, ¨
✔
Clinical condition (if relevant)
public, etc.) to whom the guideline is meant ¨
✔
Severity/stage of disease (if relevant) 3
to apply. ¨
✔
Comorbidities (if relevant)
¨
✔
Excluded populations (if relevant)
DOMAIN 2: STAKEHOLDER INVOLVEMENT
4. GROUP MEMBERSHIP ¨ Name of participant
Report all individuals who were involved in ¨ Discipline/content expertise (e.g., neurosurgeon,
✔
o
the development process. This may include methodologist)
members of the steering group, the ¨ Institution (e.g., St. Peter’s hospital)
✔ 26
research team involved in selecting and ¨ Geographical location (e.g., Seattle, WA)
✔

reviewing/rating the evidence and ¨ A description of the member’s role in the

✔

individuals involved in formulating the final guideline development group

recommendations.
5. TARGET POPULATION ¨ Statement of type of strategy used to capture
✔

PREFERENCES AND VIEWS patients’/publics’ views and preferences (e.g.,

Report how the views and preferences of participation in the guideline development group,
the target population were literature review of values and preferences)
sought/considered and what the resulting ¨ Methods by which preferences and views were
✔

outcomes were. sought (e.g., evidence from literature, surveys, 3

focus groups)
¨ Outcomes/information gathered on patient/public
✔

information
¨ How the information gathered was used to inform
✔

the guideline development process and/or

formation of the recommendations
6. TARGET USERS ¨ The intended guideline audience (e.g.
✔

Report the target (or intended) users of the specialists, family physicians, patients, clinical or
guideline. institutional leaders/administrators) 3
¨ How the guideline may be used by its target
✔

audience (e.g., to inform clinical decisions, to

inform policy, to inform standards of care)

  1
DOMAIN 3: RIGOUR OF DEVELOPMENT
7. SEARCH METHODS ¨ Named electronic database(s) or evidence
✔

Report details of the strategy used to source(s) where the search was performed (e.g.,
3
search for evidence. MEDLINE, EMBASE, PsychINFO, CINAHL)
¨ Time periods searched (e.g., January 1, 2004 to
✔ 3
March 31, 2008)
¨ Search terms used (e.g., text words, indexing
✔ 3
terms, subheadings)
¨ Full search strategy included (e.g., possibly
located in appendix)
8. EVIDENCE SELECTION CRITERIA ¨ Target population (patient, public, etc.)
Report the criteria used to select (i.e., characteristics
include and exclude) the evidence. Provide ¨ Study design
rationale, where appropriate. ¨ Comparisons (if relevant)
✔ 4
¨ Outcomes
¨ Language (if relevant)
¨ Context (if relevant)
9. STRENGTHS & LIMITATIONS OF THE ¨ Study design(s) included in body of evidence
EVIDENCE ¨ Study methodology limitations (sampling,
✔

Describe the strengths and limitations of blinding, allocation concealment, analytical 15

the evidence. Consider from the methods)
perspective of the individual studies and ¨ Appropriateness/relevance of primary and
✔

the body of evidence aggregated across all secondary outcomes considered

the studies. Tools exist that can facilitate ¨ Consistency of results across studies
✔
8-10
the reporting of this concept. ¨ Direction of results across studies
✔

¨ Magnitude of benefit versus magnitude of harm

✔

¨ Applicability to practice context

✔

10. FORMULATION OF ¨ Recommendation development process (e.g.,

✔

RECOMMENDATIONS steps used in modified Delphi technique, voting 3

Describe the methods used to formulate procedures that were considered)
the recommendations and how final ¨ Outcomes of the recommendation development
✔

decisions were reached. Specify any areas process (e.g., extent to which consensus was 4
of disagreement and the methods used to reached using modified Delphi technique,
resolve them. outcome of voting procedures)
¨ How the process influenced the
recommendations (e.g., results of Delphi
technique influence final recommendation,
alignment with recommendations and the final
vote)
11. CONSIDERATION OF BENEFITS AND ¨ Supporting data and report of benefits
✔

HARMS ¨ Supporting data and report of harms/side

✔
4
Report the health benefits, side effects, effects/risks
and risks that were considered when ¨ Reporting of the balance/trade-off between
✔ 8-14
formulating the recommendations. benefits and harms/side effects/risks
¨ Recommendations reflect considerations of both
✔ 22-23
benefits and harms/side effects/risks
12. LINK BETWEEN ¨ How the guideline development group linked and
✔

RECOMMENDATIONS AND EVIDENCE used the evidence to inform recommendations

Describe the explicit link between the ¨ Link between each recommendation and key
✔ 14-16
recommendations and the evidence on evidence (text description and/or reference list)
which they are based. ¨ Link between recommendations and evidence
✔

summaries and/or evidence tables in the results

section of the guideline

  2
13. EXTERNAL REVIEW ¨ Purpose and intent of the external review (e.g., to
✔

Report the methodology used to conduct improve quality, gather feedback on draft 2
the external review. recommendations, assess applicability and
feasibility, disseminate evidence)
¨ Methods taken to undertake the external review
(e.g., rating scale, open-ended questions)
¨ Description of the external reviewers (e.g.,
number, type of reviewers, affiliations)
¨ Outcomes/information gathered from the external
review (e.g., summary of key findings)
¨ How the information gathered was used to inform
the guideline development process and/or
formation of the recommendations (e.g.,
guideline panel considered results of review in
forming final recommendations)
14. UPDATING PROCEDURE ¨ A statement that the guideline will be updated
Describe the procedure for updating the ¨ Explicit time interval or explicit criteria to guide No
guideline. decisions about when an update will occur refier
¨ Methodology for the updating procedure e
DOMAIN 4: CLARITY OF PRESENTATION
15. SPECIFIC AND UNAMBIGUOUS ¨ A statement of the recommended action
✔

RECOMMENDATIONS ¨ Intent or purpose of the recommended action

✔
4-23
Describe which options are appropriate in (e.g., to improve quality of life, to decrease side
which situations and in which population effects)
groups, as informed by the body of ¨ Relevant population (e.g., patients, public)
✔

evidence. ¨ Caveats or qualifying statements, if relevant

✔

(e.g., patients or conditions for whom the

recommendations would not apply)
¨ If there is uncertainty about the best care
option(s), the uncertainty should be stated in the
guideline
16. MANAGEMENT OPTIONS ¨ Description of management options
✔

Describe the different options for managing ¨ Population or clinical situation most appropriate
✔
4-5-9-
the condition or health issue. to each option 10-12
17. IDENTIFIABLE KEY ¨ Recommendations in a summarized box, typed
✔

RECOMMENDATIONS in bold, underlined, or presented as flow charts 23-24

Present the key recommendations so that or algorithms
they are easy to identify. ¨ Specific recommendations grouped together in
one section
DOMAIN 5: APPLICABILITY
18. FACILITATORS AND BARRIERS TO ¨ Types of facilitators and barriers that were
✔

APPLICATION considered 2-3

Describe the facilitators and barriers to the ¨ Methods by which information regarding the
✔

guideline’s application. facilitators and barriers to implementing

recommendations were sought (e.g., feedback
from key stakeholders, pilot testing of guidelines
before widespread implementation)
¨ Information/description of the types of facilitators
✔

and barriers that emerged from the inquiry (e.g.,

practitioners have the skills to deliver the
recommended care, sufficient equipment is not
available to ensure all eligible members of the

  3
 population receive mammography)
¨ How the information influenced the guideline 2-3
development process and/or formation of the
recommendations
19. IMPLEMENTATION ADVICE/TOOLS ¨ Additional materials to support the
✔
3-4
Provide advice and/or tools on how the implementation of the guideline in practice. For
recommendations can be applied in example:
practice. o Guideline summary documents
●

o Links to check lists, algorithms

o Links to how-to manuals
●

o Solutions linked to barrier analysis (see Item

18)
o Tools to capitalize on guideline facilitators
(see Item 18)
o Outcome of pilot test and lessons learned
20. RESOURCE IMPLICATIONS ¨ Types of cost information that were considered 4
Describe any potential resource (e.g., economic evaluations, drug acquisition
implications of applying the costs)
recommendations. ¨ Methods by which the cost information was
sought (e.g., a health economist was part of the
guideline development panel, use of health
technology assessments for specific drugs, etc.)
¨ Information/description of the cost information
that emerged from the inquiry (e.g., specific drug
acquisition costs per treatment course)
¨ How the information gathered was used to inform
✔

the guideline development process and/or

formation of the recommendations
21. MONITORING/ AUDITING CRITERIA ¨ Criteria to assess guideline implementation or No
Provide monitoring and/or auditing criteria adherence to recommendations refiere
to measure the application of guideline ¨ Criteria for assessing impact of implementing the
recommendations. recommendations
¨ Advice on the frequency and interval of
measurement
¨ Operational definitions of how the criteria should
be measured
DOMAIN 6: EDITORIAL INDEPENDENCE
22. FUNDING BODY ¨ The name of the funding body or source of
✔
27
Report the funding body’s influence on the funding (or explicit statement of no funding)
content of the guideline. ¨ A statement that the funding body did not
influence the content of the guideline
23. COMPETING INTERESTS ¨ Types of competing interests considered
✔
27
Provide an explicit statement that all group ¨ Methods by which potential competing interests
members have declared whether they have were sought
any competing interests. ¨ A description of the competing interests
¨ How the competing interests influenced the
guideline process and development of
recommendations
 
From:
Brouwers MC, Kerkvliet K, Spithoff K, on behalf of the AGREE Next Steps Consortium. The AGREE Reporting Checklist: a tool to
improve reporting of clinical practice guidelines. BMJ 2016;352:i1152. doi: 10.1136/bmj.i1152.

For more information about the AGREE Reporting Checklist, please visit the AGREE Enterprise website at www.agreetrust.org.

  4
 EVALUACION AGREE II DE GPC

The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia
Guía evaluada:
2023
Nº Evaluadores: 4
Fecha 16/1/2024
Judith Salomé Gavilanes Valencia
Evaluador 1:
Bioquimica Clínica
Ruth Liliana Guevara Cadena
Evaluador 2:
Lcda en Enfermería
Jhon Fernando Maza Patiño
Evaluador 3:
Lic. en Laboratorio Clínico e Histotecnológico / Analista de Laboratorio

Evaluador 4: Cristian Paul Terán Cartagena

Lic. en Laboratorio Clínico e Histotecnológico / Analista de Laboratorio
Califique cada uno de los ítems mediante una escala de 7 puntos
(Desde el 1 "Muy en desacuerdo" hasta el 7 "Muy de acuerdo")

PUNTAJE
SECCIÓN EV. 1 EV. 2 EV. 3 EV. 4 %
FINAL
I. Alcance y Objetivo Comentarios:
1. El(los) objetivo(s) general(es) de la
Se describen claramente los
guía está(n) específicamente 7 7 7 7 28
objetivos de la guía 84 MAX
descrito(s).
2. La(s) pregunta(s) de salud cubierta(s)
Las preguntas se encuentran
por la guía está(n) específicamente 7 7 7 7 28
muy bien descritas 12 MIN
descrita(s). 100%
3. La población (pacientes, público,
La población en estudio se
etc.) a quienes se pretende aplicar la 7 7 7 7 28
encuentra perfectamente
guía están específicamente descritos.
descrito
Puntaje 21 21 21 21 84
II. Participación de los implicados Comentarios:
4. El grupo que desarrolla la guía El grupo incluye a todos los
incluye individuos de todos los grupos 7 7 7 7 28 profesionales en grupos
profesionales relevantes. relevantes 84 MAX
En este estudio si se tiene en
5. Se han tenido en cuenta los puntos
cuenta los puntos de vista y las
de vista y preferencias de la población 7 7 7 7 28 100% preferencias de la población
diana (pacientes, público, etc.). 12 MIN
en estudio
6. Los usuarios diana de la guía están En esta guía los usuarios se
7 7 7 7 28
claramente definidos. encuentran muy bien
Puntaje 21 21 21 21 84 definidos
III. Rigor en la elaboración Comentarios:
Se utilizaron métodos
7. Se han utilizado métodos sistemáticos para la realización
sistemáticos para la búsqueda de la 7 7 6 6 26 de busqueda de evidencia.
evidencia. Como PuBmed y Cochrane
Library 224 MAX
Se describe con claridad todos
los criterios para la selección
8. Los criterios para seleccionar la
7 7 7 7 28 de evidencia. Se utilizaron
evidencia se describen con claridad.
estudios controlados y
analizados. 32 MIN

Se evidencia las fortalezas

9. Las fortalezas y limitaciones del como los diferentes
conjunto de la evidencia están 6 6 7 7 26 tratamientos para el insomnio
claramente descritas y limitaciones de la evidencia
recogida en la guía

89%

V01 - 16/05/2014
 Se describen con claridad los
métodos que utilizaron para
formulación de
10. Los métodos utilizados para recomendaciones. La cual se
formular las recomendaciones están 7 7 6 6 28 realizó de acuerdo con
claramente descritos. unesquema y a través de
decisión consensuada entre
todos los autores
89% involucrados.

Si se consideran beneficios,
11. Al formular las recomendaciones
efectos secundarios y riesgos,
han sido considerados los beneficios en
7 7 7 7 28 pues en lugar de utilizar dos
salud, los efectos secundarios y los
tipos de recondaciones se
riesgos.
utilizó cuatro.

Se evidencia relación entre la

evidencia y recomendaciones
12. Hay una relación explícita entre generadas. Pues se recoge y se
cada una de las recomendaciones y las 7 7 7 7 28 analiza la evidencia en su nivel
evidencias en las que se basan. más alto y se aagrupa la s
recomendaciones en tablas
estratégicas.

La guía fue aprobada por el

13. La guía ha sido revisada por comité de guías de ESRS y por
expertos externos antes de su 7 7 7 6 27 la junta de ESRS, antes de
publicación. enviarlo al Journal of Sleep
Investigación (JSR).

No se incluye procedimiento
14. Se incluye un procedimiento para
4 4 3 3 14 para actualizar la guía de
actualizar la guía.
práctica clínica

Puntaje 52 52 50 49 203
IV. Claridad de presentación Comentarios:
La recomendación
15. Las recomendaciones son
7 7 6 6 26 proporciona información
específicas y no son ambiguas. 84 MAX
completa y precisa.
16. Las distintas opciones para el
manejo de la enfermedad o condición 7 7 7 7 28 Presentación de alternativas.
de salud se presentan claramente. 89% 12 MIN
Recomendaciones específicas
17. Las recomendaciones clave son
6 5 6 5 22 agrupadas en la tabla que
fácilmente identificables.
indica la seccion 6
Puntaje 20 19 19 18 76
V. Aplicabilidad Comentarios:

Se describen recomendaciones
para el tratamiento de la
enfermedad crónica de
18. La guía describe los facilitadores y
5 6 5 6 22 insomnio, sin embargo se
las barreras para su aplicación
recomienda ampliar la
información en cuanto a los
efectos adversos.
112 MAX

Se describe con claridad que

se utilizo mas de dos tipos de
19. La guía proporciona consejos y / o
recomendaciones y se destaca
herramientas sobre cómo las
5 5 6 6 22 que la decisión consensuada
recomendaciones se pueden poner en
se convirtió en el factor
práctica
60% decisivo para la calificación de
la recomendación
16 MIN
Solo se describe de manera
20. Se han considerado las posibles
ligera los diferentes estudios e
implicaciones de la aplicación de las
4 5 4 4 17 información utilizada para el
recomendaciones sobre
desarrollo de las
los recursos.
recomendaciones.

V01 - 16/05/2014
 No se describen criterios para
evaluar la implemtnación de la
21. La guía ofrece criterios para guia, el impacto de las
3 4 3 3 13
monitorización y/o auditoria recomendaciones o
asesoramiento sobre el
intervalo de medición.
Puntaje 17 20 18 19 74
VI. Independencia editorial Comentarios:
Se menciona el aporte
significativo de la ESRS como
22. Los puntos de vista de la entidad
entidad financiadora y la
financiadora no han influido en el 6 7 7 6 26
responsable de la aprobación
contenido de la guía.
de la guía por parte de su
comité de guías. 56 MAX
92%
23. Se han registrado y abordado los El documento mencio un
conflictos de intereses de los miembros documento complementario
7 7 6 6 26
del grupo elaborador que proporcione una
de la guía. declaración explícita. 8 MIN
Puntaje 13 14 13 12 52

EVALUACIÓN GLOBAL DE LA GUÍA

La guía posee ciertos aspectos positivos, como objetivos y preguntas

1. Puntúe la calidad global de la guía claramente definidos, métodos metodológicos sólidos, y una
entre 1 (La calidad más baja posible) a 6 presentación general clara y comprensible. Sin embargo, existen áreas
7 (La calidad más alta posible) de mejora o limitaciones en algunos dominios.

2. ¿Recomendaría esta guía para su

uso en la práctica?
Si
Si, con modificaciones X
No

NOTAS/COMENTARIOS FINALES:
La guía demuestra transparencia al describir con claridad los criterios de selección de evidencia, empleando estudios controlados y
analizados. Se identifican fortalezas, como la inclusión de diversos tratamientos para el insomnio, así como limitaciones en la evidencia
recopilada. Los métodos para la formulación de recomendaciones se detallan de manera comprensiva, con una toma de decisiones
consensuada entre los autores.BA pesar de estas fortalezas, se observan áreas de mejora, como la falta de un procedimiento para actualizar
la guía y la necesidad de ampliar la información sobre efectos adversos. Se sugiere una mayor descripción de los estudios utilizados y la
inclusión de criterios para evaluar la implementación y el impacto de las recomendaciones en intervalos de medición específicos.

Bq. Salomé Gavilanes Lic. Liliana Guevara

FIRMAS DE LOS EVALUADORES
Lic. Jhon Maza Lic. Cristian Terán

V01 - 16/05/2014