100 clinical guidelines from the AGA, ACG, ASGE, ESGE, BSG, NICE and SIGN were assessed by Malheiro et al. to determine their methodological quality. Evaluation with the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument revealed several shortcomings: not including the target population in the development process (99%), no report of facilitators and barriers to application (96%), no presentation of criteria for monitoring or auditing (94%) and no inclusion of advice or tools (86%).