AGREE II Instrument: Assessment of the Quality of Clinical Practice Guidelines
InstructorDr. Yasser Sami AmerMS Pediatrics, MS Healthcare InformaticsCPGs General Coordinator, KSUHs, AUHsMember, G-I-N Adaptation & GIRAnet Working Groups
PurposeTo guide on how to use and apply theAGREE II for assessing CPGSItemsDomainsUser’s Manual
Outlines• Overview of AGREE II including the items anddomains.• Present the scoring method of the CPG.• How to use and apply the AGREE II forassessing CPG.• Share the overall scoring.
What is the AGREE II Tool ?• Quality (Methodological rigor & transparency; confident inresulting Recommendations)4 Using the AGREE II InstrumentAssessGuide•CPGs Development•CPGs ReportingHistory1st AGREE was published in 2003,then refined in 2009 AGREE II(New scoring “7 point scale” – Items modifications – Newuser’s manual)Can be applied to anyCPG in any Diseasearea !
• Healthcare providers• CPG developers/ adapters• Policy makers• EducatorsWho can use the AGREE II ?
Considerations before a CPGAssessment• increase the reliability of the assessment2 – 4 Appraisers• in full and obtain all related information andneeded documents before undertaking theAGREE II assessment ( to make a wellinformed assessment)Read CPG first
Rating Scale• All AGREE II Items are rated on the following 7-point scaleScore Meaning7 (StronglyAgree)= If the quality of reporting is exceptional and full criteriaand considerations in User’s manual are met.1 (StronglyDisagree)= No information relevant to AGREE II item OR the conceptis very poorly reported2 – 6 = when the reporting of the item does not meet the fullcriteria or considerations, depending on the completeness& quality of reporting .
The AGREE II Includes….•Core Items23•OverallAssessment Items2
23 Items in 6 DomainsUSER’S MANUAL page 7DOMAINS No. of Items1 Scope & Purpose 32 Stakeholder Involvement 33 Rigour of Development 84 Clarity & Presentation 45 Applicability 36 Editorial Independence 2
Items and Domains: A Closer LookAGREE II:USER’S MANUALPer each Domain (guidance for rating the 23 items)Pages 11 – 41User’s Manual Description:Where to Look:How to Rate:Item content includes the following CRITERIA:Additional CONSIDERATIONS:
The cycle of development, publication, and implementation of CPGs for CKDJoseph A Vassalotti. Implementation or translation into practice should contribute to the development of asubsequent guideline, primarily through health services research. Clinical decision support is shown as theimplementation method that bridges the gap between the evidence synthesized by clinical practice guidelines andpatient care delivered through the electronic health record. The three major components of information technologyin health care are shown: the personal health record, the electronic health record, and the population health record.The arrows represent the flow of information. The arrow between the patient and the personal health record ismostly in the direction of the patient, as patient input into the electronic health record is currently limited