Description
This critical appraisal tool is used to measure the methodological rigour of clinical practice guideline development. The instrument consists of 23 items organized within six domains, followed by two global rating items for an overall assessment. Each domain captures a specific aspect of guideline development quality. AGREE II is an updated version of AGREE (2003).
Steps for Using Method/Tool
The instrument guides users through six distinct domains. Each domain includes items that are scaled from 1–7. A quality score is calculated for each of the domains, with an overall score calculated by summing all the domains. The six domains are:
- Scope and purpose – overall aim of the guideline
- Stakeholder involvement – role and expectations of stakeholders
- Rigour of development – gathering and summarizing the evidence
- Clarity of presentation – technical guidance
- Applicability – barriers and facilitators to implementation
- Editorial independence – identifying potential biases
Evaluation
Brouwers, M. C., Kho, M. E., Browman, G. P., Burgers, J. S., Cluzeau, F., Feder, G., Fervers, B., Graham, I. D., Hanna, S. E., Makarski, J., & AGREE Next Steps Consortium (2010). Development of the AGREE II, part 1: performance, usefulness and areas for improvement. CMAJ : Canadian Medical Association Journal, 182(10), 1045–1052. https://doi.org/10.1503/cmaj.091714
Brouwers, M. C., Kho, M. E., Browman, G. P., Burgers, J. S., Cluzeau, F., Feder, G., Fervers, B., Graham, I. D., Hanna, S. E., Makarski, J., & AGREE Next Steps Consortium (2010). Development of the AGREE II, part 2: assessment of validity of items and tools to support application. CMAJ : Canadian Medical Association Journal, 182(10), E472–E478. https://doi.org/10.1503/cmaj.091716
Validity
Brouwers, M. C., Kho, M. E., Browman, G. P., Burgers, J. S., Cluzeau, F., Feder, G., Fervers, B., Graham, I. D., Hanna, S. E., Makarski, J., & AGREE Next Steps Consortium (2010). Development of the AGREE II, part 2: assessment of validity of items and tools to support application. CMAJ : Canadian Medical Association Journal, 182(10), E472–E478. https://doi.org/10.1503/cmaj.091716
Reliability
Brouwers, M. C., Kho, M. E., Browman, G. P., Burgers, J. S., Cluzeau, F., Feder, G., Fervers, B., Graham, I. D., Hanna, S. E., Makarski, J., & AGREE Next Steps Consortium (2010). Development of the AGREE II, part 1: performance, usefulness and areas for improvement. CMAJ : Canadian Medical Association Journal, 182(10), 1045–1052. https://doi.org/10.1503/cmaj.091714
These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.
We have provided the resources and links as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by McMaster University of any of the products, services or opinions of the external organizations, nor have the external organizations endorsed their resources and links as provided by McMaster University. McMaster University bears no responsibility for the accuracy, legality or content of the external sites.
