Table 1

Quality of WHO guidelines on snakebite using AGREE II

GuidelineDomain 1Domain 2Domain 3Domain 4Domain 5Domain 6Overall assessment 1Overall assessment 2
Scope and purpose
(items 1–3)
Stakeholder involvement
(items 4–6)
Rigour of development
(items 7–14)
Clarity of presentation
(items 15–17)
(items 18–21)
Editorial independence
(items 22–23)
Guidelines for the management of snakebites, second edition, 201667%52%15%70%65%3%44%Yes—0;
Yes with modifications—3;
Guidelines for the prevention and clinical management of snakebite in Africa, 201054%31%16%50%29%22%33%Yes—0;
Yes with modifications—0;
  • Each of the 23 AGREE II items within each of the six domains and the quantitative overall assessment item are rated on a 7-point Likert scale (from 1—strongly disagree to 7—strongly agree). The standardised domain quality score is calculated by summing up the scores of all appraisers and standardising by scaling the total as a percentage of the maximum possible score for that domain. The scaled domain score was calculated as: {(sum of obtained score − minimum possible score) / (maximum possible score − minimum possible score)}×100. The quantitative overall assessment item, which provides the rating of the overall quality of the guideline, is not an aggregate of individual domain scores but an independent item. The qualitative overall assessment item requires the appraiser to judge—whether the guideline might be recommended for use as it is, with modifications or not recommended for use. More details about AGREE II are available at:

  • AGREE, Appraisal of Guidelines, Research and Evaluation.