Comprehensively Validated Guideline Appraisal
The AGREE II instrument has 3 goals to assess the quality of clinical practice guidelines (CPGs), provide a methodologic strategy for the development of guidelines, and recommend how and what information should be reported in guidelines. Of these, the main purpose seems to be to assess guideline quality. In 2003, an international group of guideline developers and researchers developed the Appraisal of Guidelines for Research & Evaluation (AGREE) instrument. The revised version, AGREE II, was published in 2009 and is currently the most applied and comprehensively validated guideline appraisal tool worldwide. It consists of 23 appraisal criteria (items) organized into 6 domains each of which captures a unique dimension of guideline quality. The items within each domain are rated on a 7-point scale.
AGREE II assesses CPGs based on 6 domains: scope and purpose, stakeholder involvement, the rigor of development, clarity and presentation, applicability, and editorial independence. Each domain is scored using several items. There are a total of 23 items in all – to be scored on a 7-point Likert scale by at least 2 (preferably 4) independent observers. AGREE II is designed to assess guidelines developed by local, regional, national, or international groups or affiliated governmental organizations (These include original versions of and updates of existing guidelines. The AGREE II is generic and can be applied to guidelines in any health or disease area targeting any step in the health care continuum, including those for health promotion, public health, screening, diagnosis, treatment, or interventions.