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Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
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Appendix C

AGREE II Instrument

APPRAISAL OF GUIDELINES FOR RESEARCH AND EVALUATION II

The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument is a generic tool designed to assess the quality of clinical practice guidelines. It outlines a methodological approach to evaluate guideline longevity and subsequent implementation by assessing the transparency of the guidelines and the rigor of their development. A quality score is derived by independently calculating a domain score for each of the tool’s six domains. The interpretation of this score is left to the user, and the AGREE II Consortium did not set values for minimum domain scores as they relate to the quality of a guideline. End users of this tool include health care providers, guideline developers, and policy makers (Brouwers et al., 2010).

Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
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Domain 1. Scope and Purpose

  1. The overall objective(s) of the guideline is (are) specifically described.
  2. The health question(s) covered by the guideline is (are) specifically described.
  3. The population (patients, public, etc.) to whom the guideline is meant to apply is specifically described.

Domain 2. Stakeholder Involvement

  1. The guideline development group includes individuals from all the relevant professional groups.
  2. The views and preferences of the target population (patients, public, etc.) have been sought.
  3. The target users of the guideline are clearly defined.

Domain 3. Rigor of Development

  1. Systematic methods were used to search for evidence.
  2. The criteria for selecting the evidence are clearly described.
  3. The strengths and limitations of the body of evidence are clearly described.
  4. The methods for formulating the recommendations are clearly described.
  5. The health benefits, side effects, and risks have been considered in formulating the recommendations.
  6. There is an explicit link between the recommendations and the supporting evidence.
  7. The guideline has been externally reviewed by experts prior to its publication.
  8. A procedure for updating the guideline is provided.

Domain 4. Clarity of Presentation

  1. The recommendations are specific and unambiguous.
  2. The different options for management of the condition or health issue are clearly presented.
  3. Key recommendations are easily identifiable.

Domain 5. Applicability

  1. The guideline describes facilitators and barriers to its application.
Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
×
  1. The guideline provides advice or tools on how the recommendations can be put into practice.
  2. The potential resource implications of applying the recommendations have been considered.
  3. The guideline presents monitoring or auditing criteria.

Domain 6. Editorial Independence

  1. The views of the funding body have not influenced the content of the guideline.
  2. Competing interests of guideline development group members have been recorded and addressed.

REFERENCE

Brouwers, M. C., M. E. Kho, G. P. Browman, J. S. Burgers, F. Cluzeau, G. Feder, B. Fervers, I. D. Graham, J. Grimshaw, S. E. Hanna, P. Littlejohns, J. Makarski, and L. Zitzelsberger. 2010. For the AGREE Next Steps Consortium. AGREE II: Advancing guideline development, reporting and evaluation in healthcare. Canadian Medical Association Journal 182:E839-E842.

Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
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Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
×
Page 137
Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
×
Page 138
Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
×
Page 139
Suggested Citation:"Appendix C: AGREE II Instrument." National Academies of Sciences, Engineering, and Medicine. 2018. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age. Washington, DC: The National Academies Press. doi: 10.17226/25148.
×
Page 140
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Recommended intake levels for nutrients and other dietary components were designed initially to prevent nutrient deficiency diseases in a given population, and the original methodological approach used to derive intake values did not include consideration for other applications. However, with the increasing globalization of information and the identification of a variety of factors specific to different population subgroups (e.g., young children and women of reproductive age) that influence their nutritional needs, there has been increasing recognition of the need to consider methodological approaches to deriving nutrient reference values (NRVs) that are applicable across countries and that take into account the varying needs of different population subgroups.

There is a need for guidance and recommendations about methodological approaches, as well as their potential for application to an international process for the development of NRVs, and particularly for young children and women of reproductive age. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age examines these issues and makes recommendations for a unified approach to developing NRVs that would be acceptable globally.

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