A comparison and AGREE II analysis of the revised Society for Vascular Surgery/American Venous Forum/American Vein and Lymphatic Society and European Society for Vascular Surgery clinical practice guidelines in the management of varicose veins.

Objective: The aim of this study was to compare the Society for Vascular Surgery/American Venous Forum/American Vein and Lymphatic Society (SVS/AVF/AVLS) and the European Society for Vascular Surgery (ESVS) revised Clinical Practice Guidelines (CPGs) for treatment of C2 varicose veins (VVs) by an analysis of content, methodology, level of evidence, and strength of evidence as well as by Appraisal of Guidelines for Research and Evaluation II (AGREE II) analysis.

Methods: The 2022 SVS/AVF/AVLS guidelines for VVs were compared with the 2022 ESVS CPGs on VVs for: specific methodology, evidence development, strength of recommendation, and level (quality) of evidence. Additionally, an AGREE II analysis was performed to compare the two guidelines. These guidelines were scored on six different domains as well as overall quality using a 7-point Likert scale according to the AGREE II methodology.

Results: The two CPGs differed in methodology and scope of content. The two guidelines varied significantly on their ratings of levels of evidence as well as their overall strengths of recommendations. The AGREE II analysis found that both guidelines scored as high quality in the domains of scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, editorial independence, and overall assessment. For the domain of applicability, ESVS guidelines (65.28%) scored significantly higher than SVS/AVF/AVLS guidelines (51.39%; P ≤ .05).

Conclusions: Although the methodology differed significantly between both guidelines, the overall conclusions remained similar, and both guidelines were rated as high quality by AGREE II analysis.