The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines

The international Appraisal of Guidelines, Research and Evaluation (AGREE) research team developed a tool to assess the methodological quality of practice guidelines— the original was released in 2003 (AGREE),1 and the revised and updated version in 2009 (AGREE II).2 AGREE II has become a widely used standard for evaluating the methodological quality and transparency of practice guidelines internationally.3 It was also designed to inform development and reporting requirements for practice guidelines, but these functions have often been disregarded, in part because its formatting and presentation are geared more towards use as an evaluation tool. Similarly, other tools and methods designed to guide the development of high quality practice guidelines (for example, GRADE,4 IOM Standards,5 G-I-N Standards,6 and Guidelines 2.07) are not designed specifically to guide the reporting of practice guidelines and are not generally used as such. The EQUATOR Network library (www.equator-network. org), a database of health research reporting guides, does not include any reporting checklists or guides specific to the reporting of practice guidelines. In 2003 Shiffman and colleagues released a proposed reporting framework for practice guidelines called the Conference on Guideline Standardization (COGS) checklist, based on existing resources and consensus of the COGS panel.8 This was a fundamental step forward and an asset to the guideline enterprise in providing a minimum reporting dataset for practice guidelines. However, the COGS checklist does not include key items included in the AGREE II evaluation tool that guideline users, guideline developers, and researchers have more recently deemed to be important quality aspects of practice guidelines, and its consensus process included participants from the United States, Canada, and United Kingdom only. For these reasons, the AGREE research team has developed a resource based on AGREE II, called the AGREE Reporting Checklist, specifically to facilitate reporting of practice guidelines. The AGREE Reporting Checklist is a contemporary resource based on a comprehensive review of the literature and consensus among a wider international team of practice guideline stakeholders. This article introduces the AGREE Reporting Checklist, describes its development, and outlines how it can be used.