AGREE II Instrument

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Rating Scale

Each of the AGREE II items and the two global rating items are rated on a 7-point scale (1–strongly disagree to 7–strongly agree).  The User’s Manual provides guidance on how to rate each item using the rating scale.

All AGREE II items are rated on the following 7-point scale:

Strongly disagree 1 2 3 4 5 6 7 Strongly agree

Score of 1 (Strongly Disagree)
.  A score of 1 should be given when there is no information that is relevant to the AGREE II item or if the concept is very poorly reported.

Score of 7 (Strongly Agree). A score of 7 should be given if the quality of reporting is exceptional and where the full criteria and considerations articulated in the User’s Manual have been met.

Scores between 2 and 6.   A score between 2 and 6 is assigned when the reporting of the AGREE II item does not meet the full criteria or considerations. A score is assigned depending on the completeness and quality of reporting.  Scores increase as more criteria are met and considerations addressed.   The “How to Rate” section for each item includes details about assessment criteria and considerations specific to the item.


v) Other Considerations when Applying the AGREE II

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.