Quality and Credibility of Japanese Dental Clinical Practice Guidelines: A Cross-Sectional Appraisal
T. Suzuki, A. Hasuike, S. Kikuchi, T. Watanabe, N. Watanabe, K. Ando, M. Takane, A. Chaurasia, S. SatoObjectives:
Although clinical practice guidelines (CPGs) aim to translate high-quality evidence into clinical practice, their use in Japanese dentistry remains limited. This study evaluated the methodological quality and credibility of Japanese dental CPGs.
Methods:
A cross-sectional assessment was conducted using 32 CPGs registered with the Japanese Association for Dental Science Guidelines Library. Methodological rigor and recommendation quality were independently appraised by 3 calibrated reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and the Appraisal of Guidelines for Research and Evaluation–Recommendation Excellence (AGREE-REX). Domain scores were standardized and interpreted individually, without composite scoring, and the normality of each domain was assessed using the Shapiro–Wilk test. Interrater reliability was examined using intraclass correlation coefficients, and cross-instrument domain correlations and temporal trends were analyzed.
Results:
For AGREE II, Scope and Purpose and Clarity of Presentation scored the highest, whereas Applicability was consistently the lowest. For AGREE-REX, Values and Preferences scored the lowest, indicating limited incorporation of patient values and preferences into the development of recommendations. Rigor of Development (AGREE II) was correlated with Clinical Applicability (AGREE-REX), Stakeholder Involvement (AGREE II), and Values and Preferences (AGREE-REX). Among all domains, only Editorial Independence showed significant improvement over time, with no corresponding gains in the AGREE-REX domains.
Conclusion:
Japanese dental CPGs demonstrate strong methodological rigor across several domains but remain limited in translating evidence into patient-centered, implementable recommendations. Strengthening stakeholder involvement and evidence-to-decision processes may be essential to enhance guideline uptake in clinical practice.
Knowledge Transfer Statement:
This study evaluated the methodological quality and recommendation credibility of Japanese dental clinical practice guidelines using the AGREE II and AGREE-REX instruments. These findings highlight the gaps between guideline rigor and patient-centered implementability and provide clinicians, guideline developers, and policymakers with actionable insights to improve evidence-to-decision processes and guideline uptake in dental practice.