AGREE II Instrument

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Development of the AGREE II

The original AGREE Instrument was published in 2003 by a group of international guideline developers and researchers, the AGREE Collaboration.

The objective of the Collaboration was to develop a tool to assess the quality of guidelines.  The AGREE Collaboration defined quality of guidelines as the confidence that the potential biases of guideline development have been addressed adequately and that the recommendations are both internally and externally valid, and are feasible for practice.

The assessment includes judgments about the methods used for developing the guidelines, the components of the final recommendations, and the factors that are linked to their uptake.

As with any new assessment tool, it was recognized that ongoing development was required to strengthen the measurement properties of the instrument and to ensure its usability and feasibility among intended users.  This led several members of the original team to form the AGREE Next Steps Consortium (link to page with team members).

The objectives of the Consortium were to further improve the measurement properties of the instrument, including its reliability and validity; to refine the instrument’s items to better meet the needs of the intended users; and to improve the supporting documentation (i.e., original training manual and user’s guide) to facilitate the ability of users to implement the instrument with confidence.

The result of these efforts is the AGREE II, which is comprised of the new User’s Manual and 23 item tool organized into the same six domains.

Since the tool’s publication 2010, no changes have been made to the AGREE II 23 item tool. However, in updates completed in 2013 and 2017 additional information about resources to assist with the tool’s application have been added to the introduction section and information about scoring thresholds has been added to the tools scoring section.