Journal of evaluation in clinical practice · 2026
A Critical Appraisal of Clinical Practice Guidelines for Asthma Nursing Based on the AGREE II Instrument.
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Hua Yi, Zou Bangyu, Song Jianan, Zhong Jie, Tang Yingying, Zhou Yi, Zhang Lijun
Аннотация
BACKGROUND: Asthma is a prevalent chronic respiratory disease affecting approximately 300 million people globally. While numerous CPGs (CPGs) have been released to improve patient quality of life, the methodological quality specifically regarding asthma nursing care remains unclear. This study aimed to assess the methodological quality of CPGs for asthma nursing care published since 2009 using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and to identify factors influencing guideline quality.
METHODS: Our study was undertaken using PRISMA guidelines. A systematic search was conducted across international and Chinese databases, guideline repositories, and professional association websites to retrieve relevant CPGs on 1 November 2025. Eligible guidelines were evaluated independently by four reviewers using the AGREE II instrument, which includes six domains. Inter-rater reliability was measured via intraclass correlation coefficient (ICC). Subgroup analyses were performed to explore quality differences by publication year, region, version, and number of references.
RESULTS: Eleven eligible CPGs were included. The overall ICC was 0.898, indicating excellent inter-rater reliability. Nine (81.8%) guidelines were classified as 'strongly recommended', and two (18.2%) as 'recommended with modifications'. The highest mean scores were observed in clarity of presentation (95.2%), scope and purpose (92.7%), and editorial independence (90.3%), while the lowest was in applicability (69.0%). Notably, only one guideline was specifically tailored for nursing professionals.
CONCLUSIONS: The overall methodological quality of asthma nursing CPGs is high, but gaps exist in applicability, stakeholder involvement, and rigour of development. Future guidelines should consider regional healthcare disparities, adhere to international development standards, and strengthen nursing-specific content to better support clinical practice and improve patient outcomes.
METHODS: Our study was undertaken using PRISMA guidelines. A systematic search was conducted across international and Chinese databases, guideline repositories, and professional association websites to retrieve relevant CPGs on 1 November 2025. Eligible guidelines were evaluated independently by four reviewers using the AGREE II instrument, which includes six domains. Inter-rater reliability was measured via intraclass correlation coefficient (ICC). Subgroup analyses were performed to explore quality differences by publication year, region, version, and number of references.
RESULTS: Eleven eligible CPGs were included. The overall ICC was 0.898, indicating excellent inter-rater reliability. Nine (81.8%) guidelines were classified as 'strongly recommended', and two (18.2%) as 'recommended with modifications'. The highest mean scores were observed in clarity of presentation (95.2%), scope and purpose (92.7%), and editorial independence (90.3%), while the lowest was in applicability (69.0%). Notably, only one guideline was specifically tailored for nursing professionals.
CONCLUSIONS: The overall methodological quality of asthma nursing CPGs is high, but gaps exist in applicability, stakeholder involvement, and rigour of development. Future guidelines should consider regional healthcare disparities, adhere to international development standards, and strengthen nursing-specific content to better support clinical practice and improve patient outcomes.