Endometriosis is a common gynaecological condition among women of reproductive age that results in an array of problems including pelvic pain, dysmenorrhoea, dyspareunia and subfertility. There is a lack of consensus about its best management, particularly in dealing with symptoms of chronic pelvic pain. Guidelines are systematically developed statements to assist practitioner and patients’ decisions about appropriate health care for specific clinical circumstances.1 Their specific purpose is to make explicit recommendations with a definite intent to influence what clinicians do.2 It is believed that guidelines can improve the quality, appropriateness and cost-effectiveness of health care in endometriosis.
The methodology for development of high-quality guidelines requires that the recommendations should be evidence based. Validated and reliable appraisal tools3,4 can be used to assess the quality of a guideline, which may provide an assessment of its predicted validity, i.e. the likelihood that it will achieve its intended outcome. However, previous studies of guideline quality have shown that they are often poor in compliance with criteria concerning applicability, i.e. the likely organisational, behavioural and cost implications of applying the guideline. We identified existing guidelines for the management of pain associated with endometriosis and assessed their quality using two such tools, the Cluzeau3 and the Appraisal of Guidelines and Research and Evaluation4 (AGREE) instruments. We also examined if their compliance with quality criteria concerning scope or content and rigour of development was better than that with the criteria concerning applicability of recommendations.