Another meta-review by Knai et al 15 of 28 European guidelines on a range of topics published from 2000 to 2007 similarly found that most guidelines scored low for applicability (mean 44%, range 0 100%) relative to all domains but editorial independence.
Two reporting guidelines were added for applicability to studies involving Hispanic or Latino populations ("Provision of instructions for device wear in Spanish") and studies using pedometers ("Total step counts").
9 11 A metareview by Alonso-Coello et al 14 of 42 studies in which 626 guidelines on a range of topics published in various countries from 1980 to 2007 were assessed with AGREE found that most guidelines scored low for applicability (mean 22%, 95% CI 20.4% to 23.9%) relative to all other domains.
For the remaining domains, however, the guidelines did not perform as well, as follows: for stakeholder involvement, 41 guidelines (80%) scored < 50%; for rigor of development, 29 guidelines (57%) scored < 50%; for clarity and presentation, 17 guidelines (33%) scored < 50%; for applicability, 46 guidelines (90%) scored < 50%; and for editorial independence, 47 guidelines (92%) scored < 50%.
As for guideline applicability, barriers in guideline use should be taken into account during guideline development, in order to facilitate use and uptake [ 20, 21].
Lack of user involvement and attention for applicability in guideline development increase the likelihood of erroneous assumptions underpinning guidelines, with detrimental effects on the applicability of guidelines.
ISO/IEC 20000 2 and ISO/IEC TR 20000 5 present practices and an example of a management plan to achieve the requirements, respectively (ISO/IEC,20122010b). ISO/IEC TR 20000 3 provides guidelines for defining the scope, applicability, and conformity demonstration of the service management system (ISO/IEC,2009).
The mean and median domain scores for applicability across all guidelines were 43.6% and 42.0%, respectively.
The mean and median domain scores for applicability across 137 guidelines published in 2008 or later were 43.6% and 42.0% (IQR 21.8 63.0%), respectively.
Guidelines published in 2007 and earlier assessed with the Appraisal of Guidelines, Research and Evaluation (AGREE) instrument scored poorly for applicability, which reflects the inclusion of implementation instructions or tools.
