AGREE II Instrument

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AGREE II Instructions

The AGREE II is a tool developed to access the methodological quality of practice guidelines.

The tool can be used by:

  • Guideline developers;
  • Policy makers, health administrator, program managers and professional organizations; and
  • Stakeholders (including patients/consumers, health professionals, researchers, educators and other stakeholders interested in the development and uptake of clinical guidelines).

The AGREE II is comprised of 23 items organized into 6 quality domains:

  1. Scope and purpose;
  2. Stakeholder involvement;
  3. Rigour of development;
  4. Clarity of presentation;
  5. Applicability; and
  6. 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 judgements of the practice guideline while considering how they rated the 23 items.

The 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.

Appraisal Process:

  • It is recommended that at least two, and preferably four, appraisers review each clinical guideline to increase the reliability of the assessment.
  • Before applying the tool, users should read the clinical guideline document in full, as well as any accompanying documents.
  • 2 scoring methods
    • Method 1: Using individual appraisers’ scores
    • Method 2: Reaching consensus
  • Purpose of scoring:
    • To identify limitations of the clinical guideline being considered
    • To select high quality clinical guidelines to implement

Additional information can be found in the AGREE II tool user manual, download it here.

If you have additional questions about the AGREE II, you can visit the AGREE II FAQ webpage or send us your question by contacting us.