Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Mar;28(3):357-65.
doi: 10.3346/jkms.2013.28.3.357. Epub 2013 Mar 4.

Assessment of the quality of clinical practice guidelines in Korea using the AGREE Instrument

Min-Woo Jo  1 , Jin Yong Lee, Nam-Soon Kim, Soo-Young Kim, Seungsoo Sheen, Seon Ha Kim, Sang-Il Lee
Affiliations
Review

Assessment of the quality of clinical practice guidelines in Korea using the AGREE Instrument

Min-Woo Jo et al. J Korean Med Sci. 2013 Mar.

Abstract

The objective of this study was to conduct the systematic evaluation of methodological quality of clinical practice guidelines (CPGs) in Korea. The authors conducted a very comprehensive literature search to identify potential CPGs for evaluation. CPGs were selected which were consistent with a predetermined criteria. Four reviewers evaluated the quality of the CPGs using the Appraisal of Guidelines, Research and Evaluation (AGREE) Instrument. AGREE item scores and standardized domain scores were calculated. The inter-rater reliability of each domain was evaluated using the intra-class correlation coefficient (ICC). Consequently, 66 CPGs were selected and their quality evaluated. ICCs for CPG appraisal using the AGREE Instrument ranged from 0.626 to 0.877. Except for the "Scope and Purpose" and "Clarity and Presentation domains", 80% of CPGs scored less than 40 in all other domains. This review shows that many Korean research groups and academic societies have made considerable efforts to develop CPGs, and the number of CPGs has increased over time. However, the quality of CPGs in Korea were not good according to the AGREE Instrument evaluation. Therefore, we should make more of an effort to ensure the high quality of CPGs.

Keywords: Clinical Practice Guideline; Quality Improvement.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart showing selection of clinical practice guidelines.
Fig. 2
Fig. 2
Distribution of standardized domain scores for 66 clinical practice guidelines. The top and bottom of the box represents the 75th (Q3) and 25th percentile (Q1), respectively, and the band near the middle of the box indicates the 50th percentile (the median). The upper and lower ends of the whisker represent Q3 + 1.5 × (interquartile range), and Q1-1.5 × (interquartile range), respectively. Small dot (○) represents outlier values which lies more than 1.5 times to 3.0 times interquartile range from either end of the whisker. Asterisk (*) represents extreme outlier values which lies more than 3 times interquartile range from either end of the whisker.
See this image and copyright information in PMC

References

    1. Field MJ, Lohr KN. Clinical practice guidelines: directions for a new program. Washington, D.C.: National Academy Press; 1990. - PubMed
    1. Pauly MV, Eisenberg JM, Radany MH, Erder MH, Feldman R, Schwartz JS. Paying physicians: options for controlling cost, volume, and intensity of services. Ann Arbor: Health Administration Press; 1992.
    1. Burgers JS, Grol R, Klazinga NS, Mäkelä M, Zaat J AGREE Collaboration. Towards evidence-based clinical practice: an international survey of 18 clinical guideline programs. Int J Qual Health Care. 2003;15:31–45. - PubMed
    1. AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care. 2003;12:18–23. - PMC - PubMed
    1. Nagy E, Watine J, Bunting PS, Onody R, Oosterhuis WP, Rogic D, Sandberg S, Boda K, Horvath AR IFCC Task Force on the Global Campaign for Diabetes Mellitus. Do guidelines for the diagnosis and monitoring of diabetes mellitus fulfill the criteria of evidence-based guideline development? Clin Chem. 2008;54:1872–1882. - PubMed

Publication types