Development of the AGREE II, part 1: performance, usefulness and areas for improvement
Development of the AGREE II, part 1: performance, usefulness and areas for improvement
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DOI：
10.1503/cmaj.091714
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发表时间：
2010-07-13
影响因子：
14.6
通讯作者：
Makarski, Julie
中科院分区：
文献类型：
--
作者：
Brouwers, Melissa C.;Kho, Michelle E.;Makarski, Julie
背景：我们进行了研究，以改善AGREE工具，用于评估指南的工具。我们测试了一个新的七点量表，评估仪器中的原始项目的有用性，调查证据，以支持较短的，量身定制的版本的工具，并确定领域improvementation.Method：我们报告的一个组成部分的一个更大的研究，使用了混合设计与四个因素（用户类型，临床主题，指南和条件）。在这篇文章中报告的分析，我们要求参与者阅读指南，并使用AGREE项目进行评估的基础上的七点量表，完成三个结果的措施有关通过的指南，并提供反馈的工具的有用性和如何改进it.Results：指南开发商给出了较低的质量评级比临床医生或政策制定者。六个领域中的五个是参与者结果测量的显著预测因子（p < 0.05）。所有领域和项目都被利益相关者评为有用（平均得分> 4.0），不同用户类型之间没有显著差异（p > 0.05）。内部一致性介于0.64和0.89之间。评价者间信度令人满意。我们收到的反馈意见，如何改善instrument.Interpretation：质量评级的AGREE域的结果与准则采用的措施：准则认可，整体意图使用指南，和整体质量的指南是显着的预测。所有AGREE项目都被评估为在确定参与者是否会使用指南时有用。一些用户发现没有任何项目集群比其他用户更有用。七点量表的测量性能是有前途的。这些数据有助于AGREE II的改进和发布。
Background: We undertook research to improve the AGREE instrument, a tool used to evaluate guidelines. We tested a new seven-point scale, evaluated the usefulness of the original items in the instrument, investigated evidence to support shorter, tailored versions of the tool, and identified areas for improvement.Method: We report on one component of a larger study that used a mixed design with four factors (user type, clinical topic, guideline and condition). For the analysis reported in this article, we asked participants to read a guideline and use the AGREE items to evaluate it based on a seven-point scale, to complete three outcome measures related to adoption of the guideline, and to provide feedback on the instrument's usefulness and how to improve it.Results: Guideline developers gave lower-quality ratings than did clinicians or policy-makers. Five of six domains were significant predictors of participants' outcome measures (p < 0.05). All domains and items were rated as useful by stakeholders (mean scores > 4.0) with no significant differences by user type (p > 0.05). Internal consistency ranged between 0.64 and 0.89. Inter-rater reliability was satisfactory. We received feedback on how to improve the instrument.Interpretation: Quality ratings of the AGREE domains were significant predictors of outcome measures associated with guideline adoption: guideline endorsements, overall intentions to use guidelines, and overall quality of guidelines. All AGREE items were assessed as useful in determining whether a participant would use a guideline. No clusters of items were found more useful by some users than others. The measurement properties of the seven-point scale were promising. These data contributed to the refinements and release of the AGREE II.