AGREE II Instrument

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Introduction to AGREE II

The AGREE instrument is a tool that assesses the methodological rigour and transparency in which a guideline is developed and it is used internationally.

The Appraisal of Guidelines for Research & Evaluation (AGREE) Instrument was developed to address the issue of variability in the quality of practice guidelines.

It is important to assess the methods used to develop practice guidelines in order to be confident of the resulting recommendations.  The AGREE instrument is a tool that assesses the methodological rigour and transparency in which a guideline is developed and it is used internationally.

The original AGREE Instrument, which was released in 2003, has been refined to improve the original tool’s usability and methodological properties, namely its validity and reliability.  These efforts have resulted in the new AGREE II tool that also includes a new User’s Manual.

The AGREE II is both valid and reliable and comprises 23 items organized into the original 6 quality domains: i) scope and purpose; ii) stakeholder involvement; iii) rigour of development; iv) clarity of presentation; v) applicability; and vi) editorial independence.   Each of the 23 items targets various aspects of practice guideline quality.  The AGREE II also includes 2 final overall assessment items that requires the appraiser to make overall judgments of the practice guideline and considering how they rated the 23 items.

The new User’s Manual is designed to guide appraisers in the use of the AGREE II.  The Manual is part of the complete AGREE II document or “package” and includes specific information and guidance for each of the 23 items and the 2 overall assessment items.