7.5. Critical appraisal of guidelines

For the quality appraisal of clinical practice guidelines, the AGREE II instrument (www.agreetrust.org) is recommended. AGREE II comprises 23 items organized into 6 quality domains: i) scope and purpose; ii) stakeholder involvement; iii) rigour of development; iv) clarity of presentation; v) applicability; and vi) editorial independence. Each of the 23 items targets various aspects of practice guideline quality and can be scored on a scale from 1 (strongly disagree) to 7 (strongly agree). Two global rating items allow an overall assessment of the guideline’s quality. Detailed scoring information is provided in the instrument in attachment.

Ideally, the quality appraisal of a guideline is done by 4 reviewers, but because of feasibility 2 reviewers can be considered acceptable.

AGREE II serves 3 purposes:

1. to assess the quality of guidelines;

2. to provide a methodological strategy for the development of guidelines; and

3. to inform what information and how information ought to be reported in guidelines.