Quality of 2019 American Optometric Association clinical practice guideline for diabetic eye care

Purpose: The 2019 American Optometric Association (AOA) clinical practice guideline intends to assist optometrists in providing evidence-based eye care for people with diabetes. This technical report evaluated the methodological and reporting quality of the guideline. 

Methods: Four independent reviewers appraised the 2014 and 2019 versions of the AOA’s guideline using the AGREE II instrument. Average scaled scores across the six domains of the AGREE II and an overall independent score were calculated based on the formula provided. 

Results: The 2019 guideline scored high (range: 75–93%) in all domains except for the domain of applicability (34%). In the domain of rigour of development, significant improvements were noted in the 2019 guideline (median score: 7.0, interquartile range (IQR): 6.0–7.0) compared to the 2014 guideline (median: 5.0, IQR: 4.0–6.0) (p < 0.0001). The appraisal of the guideline also identified room for further improvements, especially in relation to implementing the guideline. 

Conclusion: The overall and domain specific quality of the AOA 2019 guideline was high, however, improvement in its applicability domain is required. The findings of this study will aid uptake of the guideline and inform improvement efforts for other international optometric guidelines.