The AGREE II Instrument

An online version of the AGREE II Instrument, the international tool for critically appraising the quality of clinical practice guidelines.

The Challenge

Clinical practice guidelines are a cornerstone of modern medicine.  These documents are supposed to set out the best practice recommendations for the management of clinical conditions.  It is therefore imperative that they are reliable and usable.

The AGREE II Instrument is widely used by health care organisations and practitioners around the world to evaluate guidelines.

AGREE asked Minervation to help them build an online version of the Instrument called “MyAGREE”.  It’s a 26-point checklist, each item scored out of 7, and each contributing to specific domain scores. Users needed to be able to save their progress, share results and collaborate across remote locations in conducting their appraisals.  They also needed easy access to a manual of instructions to help them understand the criteria.

<p>Walk through the AGREE II appraisal process, referring to official guidance for each question on-screen.  Results are tallied at the end in an overall assessment.</p>

Walk through the AGREE II appraisal process, referring to official guidance for each question on-screen.  Results are tallied at the end in an overall assessment.

<p>The MyAGREE Plus dashboard helps you to manage your contributions to group efforts, and a run a team of your own.</p>

The MyAGREE Plus dashboard helps you to manage your contributions to group efforts, and a run a team of your own.

The Solution

There’s often a danger of over-complicating these types of applications to the point where they become unusable. The old sledgehammer to crack a nut problem. So, we took a user-centred approach to this task and started by recruiting an international representative group of users, including senior UK and US guideline users.

We guided the group through iterations of the scope, specification, wireframe and pilot system, towards a user-friendly, intuitive design with minimal clutter.  This was then thoroughly tested to make sure it cut the mustard.

The proof of the pudding is in the eating. Over 70,000 users have registered to use the site to date, completing with over 100,000 completed guideline appraisals.

The AGREE Trust also liked what they saw: they called us back in to extend the functionality into the “MyAGREE PLUS” platform for managing and combining multiple appraisals by different assessors.  This has also been very popular, particularly with universities and guideline developers.  18,000 group appraisals have been completed since 2017.

“It has been an absolute pleasure working with you over the past few years – truly.  Thank you for all of your contributions, efforts, collegiality, leadership and more in our projects and the AGREE-Minervation relationship.”

Julie Makarski

Julie Makarski

McMaster University

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