The ESCP Guideline Committee collaborates with many other international societies; the ESCP is a member society of UEG and we are represented on their Quality of Care Taskforce. We would like to endorse the "UEG Framework for the development of high quality clinical guidelines".

This paper explains very thoroughly the different steps which need to be taken on how to conduct a high-quality guideline. 


The processes and methods used by ESCP to establish guidelines are informed by internationally recognised criteria of quality of guidelines, as detailed in the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.

The guidelines are prepared by guideline development groups (GDG) which typically consist of clinical and methodological experts and relevant stakeholders including patients. Early in the guideline development process, the GDG will define outcomes that are considered ‘critical’ or ‘important’ for decision making.

Download: The development of ESCP's Guideline for Haemorrhoidal Disease (PDF)

The GRADE system is then used to assess the quality of the evidence by looking at features of the evidence found for each 'critical' and 'important' outcome. GRADE enables classification of levels of evidence as high, moderate, low or very low.

These levels of evidence subsequently inform the strength of the recommendations made in the guidelines. By following the principles laid down by AGREE and GRADE, together with input from our clinical experts, consumers and stakeholders, ESCP is confident that high quality international guidelines can be made available.

Below is Jos Kleijnen's presentation 'Preparing Guidelines: the role of evidence, the role of GRADE and the role of AGREE' at ESCP Nice 2018.

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