Appraisal of 11 ANCA-associated vasculitis guidelines identifies implementation and patient-involvement gaps

An appraisal published in Clinical Kidney Journal evaluated the methodological quality of 11 currently available guidelines for ANCA-associated vasculitis. Four reviewers independently applied the AGREE II instrument, which comprises 23 items across six domains, and calculated scaled domain scores.

The average overall guideline score was 4.5 ± 0.8 out of 7, with excellent agreement between reviewers. The British Society for Rheumatology 2025 guideline scored highest at 5.8 out of 7 and was the only guideline unanimously recommended for use. Scope and purpose scored highly across all guidelines; most also scored highly for rigour of development and clarity of presentation. Editorial independence was generally well addressed.

Applicability received the lowest scores, reflecting insufficient implementation tools, attention to resource and cost implications, assessment of barriers and facilitators, and monitoring or auditing criteria. Patient views and preferences were also inadequately represented, and procedures for updating guidelines and external review were poorly addressed.

The findings highlight methodological and implementation weaknesses rather than comparative effectiveness of treatment recommendations. The authors call for greater patient involvement and clearer processes for translating recommendations into practice and monitoring uptake. Only the abstract was available for this report, limiting assessment of individual guideline results and appraisal methods.