The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Knowing what Works in Health Care: A Roadmap for the Nation
Appendix F
Guideline Standards: The AGREE Instrument and COGS Checklist
THE APPRAISAL OF GUIDELINES RESEARCH ANDEVALUATION (AGREE) INSTRUMENT1
Scope and Purpose
The overall objective(s) of the guideline is (are) specifically described.
The clinical question(s) covered by the guideline is (are) specifically described.
The patients to whom the guideline is meant to apply are specifically described.
Stakeholder Involvement
The guideline development group includes individuals from all the relevant professional groups.
The patients’ views and preferences have been sought.
The target users of the guideline are clearly defined.
The guideline has been piloted among target users.
Rigour of Development
Systematic methods were used to search for evidence.
The criteria for selecting the evidence are clearly described.
The methods used for formulating the recommendations are clearly described.
1
Reprinted in adapted format, with permission, from the AGREE Research Trusthttp://www.agreetrust.org. Copyright 2006 by the AGREE Research Trust.
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole. Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 231
Knowing what Works in Health Care: A Roadmap for the Nation
Appendix F
Guideline Standards: The AGREE Instrument and COGS Checklist
THE APPRAISAL OF GUIDELINES RESEARCH AND EVALUATION (AGREE) INSTRUMENT1
Scope and Purpose
The overall objective(s) of the guideline is (are) specifically described.
The clinical question(s) covered by the guideline is (are) specifically described.
The patients to whom the guideline is meant to apply are specifically described.
Stakeholder Involvement
The guideline development group includes individuals from all the relevant professional groups.
The patients’ views and preferences have been sought.
The target users of the guideline are clearly defined.
The guideline has been piloted among target users.
Rigour of Development
Systematic methods were used to search for evidence.
The criteria for selecting the evidence are clearly described.
The methods used for formulating the recommendations are clearly described.
1
Reprinted in adapted format, with permission, from the AGREE Research Trust http://www.agreetrust.org. Copyright 2006 by the AGREE Research Trust.
OCR for page 232
Knowing what Works in Health Care: A Roadmap for the Nation
The health benefits, side effects and risks have been considered in formulating the recommendations.
There is an explicit link between the recommendations and the supporting evidence.
The guideline has been externally reviewed by experts prior to its publication.
A procedure for updating the guideline is provided.
Clarity and Presentation
The recommendations are specific and unambiguous.
The different options for management of the condition are clearly presented.
Key recommendations are easily identifiable.
The guideline is supported with tools for application.
Applicability
The potential organisational barriers in applying the recommendations have been discussed.
The potential cost implications of applying the recommendations have been considered.
The guideline presents key review criteria for monitoring and/or audit purposes.
Editorial Independence
The guideline is editorially independent from the funding body.
Conflicts of interest of guideline development members have been recorded.
OCR for page 233
Knowing what Works in Health Care: A Roadmap for the Nation
CONFERENCE ON GUIDELINES STANDARDIZATION (COGS) CHECKLIST FOR REPORTING CLINICAL PRACTICE GUIDELINES2
Topic
Description
1. Overview material
Provide a structured abstract that includes the guideline’s release date, status (original, revised, updated), and print and electronic sources.
2. Focus
Describe the primary disease/condition and intervention/service/technology that the guideline addresses. Indicate any alternative preventive, diagnostic or therapeutic interventions that were considered during development.
3. Goal
Describe the goal that following the guideline is expected to achieve, including the rationale for development of a guideline on this topic.
4. Users/setting
Describe the intended users of the guideline (e.g., provider types, patients) and the settings in which the guideline is intended to be used.
5. Target population
Describe the patient population eligible for guideline recommendations and list any exclusion criteria.
6. Developer
Identify the organization(s) responsible for guideline development and the names/ credentials/potential conflicts of interest of individuals involved in the guideline’s development.
7. Funding source/sponsor
Identify the funding source/sponsor and describe its role in developing and/or reporting the guideline. Disclose potential conflict of interest.
8. Evidence Collection
Describe the methods used to search the scientific literature, including the range of dates and databases searched, and criteria applied to filter the retrieved evidence.
2
Reprinted, with permission, from Annals of Internal Medicine 2003. Copyright 2007 by the American College of Physicians.
OCR for page 234
Knowing what Works in Health Care: A Roadmap for the Nation
Topic
Description
9. Recommendation grading criteria
Describe the criteria used to rate the quality of evidence that supports the recommendations and the system for describing the strength of the recommendations. Recommendation strength communicates the importance of adherence to a recommendation and is based on both the quality of the evidence and the magnitude of anticipated benefits or harms.
10. Method for synthesizing evidence
Describe how evidence was used to create recommendations, e.g., evidence tables, meta-analysis, decision analysis.
11. Prerelease review
Describe how the guideline developer reviewedand/or tested the guidelines prior to release.
12. Update plan
State whether or not there is a plan to update the guideline and, if applicable, an expiration date for this version of the guideline.
13. Definitions
Define unfamiliar terms and those critical to correct application of the guideline that might be subject to misinterpretation.
14. Recommendations and rationale
State the recommended action precisely and the specific circumstances under which to perform it. Justify each recommendation by describing the linkage between the recommendation and its supporting evidence. Indicate the quality of evidence and the recommendation strength, based on the criteria described in 9.
15. Potential benefits and harms
Describe anticipated benefits and potential risks associated with implementation of guideline recommendations.
16. Patient preferences
Describe the role of patient preferences when a recommendation involves a substantial element of personal choice or values.
17. Algorithm
Provide (when appropriate) a graphical description of the stages and decisions in clinical care described by the guideline.
OCR for page 235
Knowing what Works in Health Care: A Roadmap for the Nation
Topic
Description
18. Implementation considerations
Describe anticipated barriers to application of the recommendations. Provide reference to any auxiliary documents for providers or patients that are intended to facilitate.
REFERENCES
The AGREE Collaboration. 2001. The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. London, UK: The AGREE Research Trust http://www.agreetrust.org/docs/AGREE_Instrument_English.pdf (accessed September 2007).
Shiffman, R. N., P. Shekelle, M. Overhage, J. Slutsky, J. Grimshaw, and A. M. Deshpande. 2003. Standardized reporting of clinical practice guidelines: A proposal from the Conference on Guideline Standardization. Annals of Internal Medicine 139(6):493-500.
OCR for page 236
Knowing what Works in Health Care: A Roadmap for the Nation
This page intentionally left blank.
Items in cart [1]
