Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age (2018)
Chapter: Appendix C: AGREE II Instrument
Appendix C
AGREE II Instrument
APPRAISAL OF GUIDELINES FOR RESEARCH AND EVALUATION II
The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument is a generic tool designed to assess the quality of clinical practice guidelines. It outlines a methodological approach to evaluate guideline longevity and subsequent implementation by assessing the transparency of the guidelines and the rigor of their development. A quality score is derived by independently calculating a domain score for each of the tool’s six domains. The interpretation of this score is left to the user, and the AGREE II Consortium did not set values for minimum domain scores as they relate to the quality of a guideline. End users of this tool include health care providers, guideline developers, and policy makers (Brouwers et al., 2010).
Domain 1. Scope and Purpose
- The overall objective(s) of the guideline is (are) specifically described.
- The health question(s) covered by the guideline is (are) specifically described.
- The population (patients, public, etc.) to whom the guideline is meant to apply is specifically described.
Domain 2. Stakeholder Involvement
- The guideline development group includes individuals from all the relevant professional groups.
- The views and preferences of the target population (patients, public, etc.) have been sought.
- The target users of the guideline are clearly defined.
Domain 3. Rigor of Development
- Systematic methods were used to search for evidence.
- The criteria for selecting the evidence are clearly described.
- The strengths and limitations of the body of evidence are clearly described.
- The methods for formulating the recommendations are clearly described.
- The health benefits, side effects, and risks have been considered in formulating the recommendations.
- There is an explicit link between the recommendations and the supporting evidence.
- The guideline has been externally reviewed by experts prior to its publication.
- A procedure for updating the guideline is provided.
Domain 4. Clarity of Presentation
- The recommendations are specific and unambiguous.
- The different options for management of the condition or health issue are clearly presented.
- Key recommendations are easily identifiable.
Domain 5. Applicability
- The guideline describes facilitators and barriers to its application.
- The guideline provides advice or tools on how the recommendations can be put into practice.
- The potential resource implications of applying the recommendations have been considered.
- The guideline presents monitoring or auditing criteria.
Domain 6. Editorial Independence
- The views of the funding body have not influenced the content of the guideline.
- Competing interests of guideline development group members have been recorded and addressed.
REFERENCE
Brouwers, M. C., M. E. Kho, G. P. Browman, J. S. Burgers, F. Cluzeau, G. Feder, B. Fervers, I. D. Graham, J. Grimshaw, S. E. Hanna, P. Littlejohns, J. Makarski, and L. Zitzelsberger. 2010. For the AGREE Next Steps Consortium. AGREE II: Advancing guideline development, reporting and evaluation in healthcare. Canadian Medical Association Journal 182:E839-E842.
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