On occasion, some AGREE II items may not be applicable to the particular guideline under review.
For example, guidelines narrow in scope may not provide the full range of options for the management of the condition (see item 16). AGREE II does not include a “Not Applicable” response item in its scale.
There are different strategies to manage this situation including having appraisers skip that item in the assessment process or rating the item as 1 (absence of information) and providing context about the score.
Regardless of strategy chosen, decisions should be made in advance, described in an explicit manner, and if items are skipped, appropriate modifications to calculating the domain scores should be implemented.
As a principle, excluding items in the appraisal process is discouraged.
