使用AGREE II进行指南评估：关于AGREE II项目对指南质量总体评估及使用建议潜在影响的在线调查
Guideline appraisal with AGREE II: online survey of the potential influence of AGREE II items on overall assessment of guideline quality and recommendation for use.
作者信息
Hoffmann-Eßer Wiebke, Siering Ulrich, Neugebauer Edmund A M, Brockhaus Anne Catharina, McGauran Natalie, Eikermann Michaela
机构信息
Institute for Quality and Efficiency in Health Care (IQWiG), Im Mediapark 8, 50670, Cologne, Germany.
Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Campus Cologne, Cologne, Germany.
出版信息
BMC Health Serv Res. 2018 Feb 27;18(1):143. doi: 10.1186/s12913-018-2954-8.
BACKGROUND
The AGREE II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within six domains. AGREE II also includes two overall assessments (overall guideline quality, recommendation for use). Our aim was to investigate how strongly the 23 AGREE II items influence the two overall assessments.
METHODS
An online survey of authors of publications on guideline appraisals with AGREE II and guideline users from a German scientific network was conducted between 10th February 2015 and 30th March 2015. Participants were asked to rate the influence of the AGREE II items on a Likert scale (0 = no influence to 5 = very strong influence). The frequencies of responses and their dispersion were presented descriptively.
RESULTS
Fifty-eight of the 376 persons contacted (15.4%) participated in the survey and the data of the 51 respondents with prior knowledge of AGREE II were analysed. Items 7-12 of Domain 3 (rigour of development) and both items of Domain 6 (editorial independence) had the strongest influence on the two overall assessments. In addition, Items 15-17 (clarity of presentation) had a strong influence on the recommendation for use. Great variations were shown for the other items. The main limitation of the survey is the low response rate.
CONCLUSIONS
In guideline appraisals using AGREE II, items representing rigour of guideline development and editorial independence seem to have the strongest influence on the two overall assessments. In order to ensure a transparent approach to reaching the overall assessments, we suggest the inclusion of a recommendation in the AGREE II user manual on how to consider item and domain scores. For instance, the manual could include an a-priori weighting of those items and domains that should have the strongest influence on the two overall assessments. The relevance of these assessments within AGREE II could thereby be further specified.
背景
AGREE II工具是最常用的指南评估工具。它包括23条评估标准（项目），分为六个领域。AGREE II还包括两项总体评估（总体指南质量、使用建议）。我们的目的是研究AGREE II的23个项目对这两项总体评估的影响程度。
方法
2015年2月10日至2015年3月30日，对使用AGREE II进行指南评估的出版物作者以及德国一个科学网络的指南使用者进行了在线调查。参与者被要求按照李克特量表（0=无影响至5=影响非常强烈）对AGREE II项目的影响进行评分。对回答的频率及其离散程度进行了描述性呈现。
结果
联系的376人中，58人（15.4%）参与了调查，对51名了解AGREE II的受访者的数据进行了分析。第3领域（制定的严谨性）的第7至12项以及第6领域（编辑独立性）的两项对两项总体评估影响最大。此外，第15至17项（呈现的清晰度）对使用建议有很大影响。其他项目显示出很大差异。该调查的主要局限性是回复率低。
结论
在使用AGREE II进行指南评估时，代表指南制定的严谨性和编辑独立性的项目似乎对两项总体评估影响最大。为确保采用透明的方法得出总体评估结果，我们建议在AGREE II用户手册中纳入关于如何考虑项目和领域得分的建议。例如，手册可以包括对那些应对两项总体评估影响最大的项目和领域进行先验加权。从而可以进一步明确这些评估在AGREE II中的相关性。
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