To identify and critically appraise available clinical practice guidelines (CPGs) targeting male circumcision using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument.
A literature search using electronic databases, CPG databases, and national/international societies providing recommendations to guide clinical decision-making for MC was conducted. We selected pediatric-focused CPGs related to MC published from January 2010 to December 2020. Non-English CPGs and publications involving narrative reviews, primary research, training manuals, patient and allied health professional guidelines, and technical guides were excluded from our search. Full CPG documents (including full-text articles, supplemental documents, and associated information) were reviewed. Quality appraisal of CPGs was conducted in accordance with the AGREE II manual.
A total of 163 CPGs were identified from which 93 were screened and 13 reviewed. All AGREE II domains demonstrated good to excellent inter-rater reliability with intraclass correlation coefficients ranging from 0.82 (95% CI: 0.72-0.89) to 0.93 (95% CI: 0.90-0.95). Most CPGs performed satisfactorily in the clarity of presentation domain and performed poorly in the applicability and editorial independence domains. The top three CPGs identified were the American Academy of Pediatrics, Centers for Disease Control and Prevention, and Canadian Urological Association guidelines. Consistencies between the CPGs were demonstrated across most recommendations.
Current clinical practice guidelines possess variable quality that should be considered by clinicians when referring to MC CPGs. Our findings should be taken into consideration by clinicians and health care professionals when selecting appropriate guidelines.

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