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DNP 820 Week 3: appraising a guideline with AGREE II

AGREE II appraises how a guideline was made, not whether you agree with it — so a guideline you doubted can still score well, and noticing that is what the assignment is teaching.

Editorial process

Last reviewed · August 15, 2026

01

A guideline you doubted is the right starting point

Choose a guideline you have actually questioned, since the instruction says so and it makes the exercise real: a recommendation your unit follows without conviction, one that conflicts with another body's advice, or one whose evidence base you suspect is thinner than its confidence suggests. Then understand what the instrument does before you score anything. AGREE II assesses the rigour of the guideline's development process across six domains — scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence — and it deliberately does not assess whether the recommendations are clinically correct. That distinction is the lesson: a guideline you disagree with may be methodologically excellent, and a guideline you like may score badly on rigour, and both outcomes are informative. Noticing that is more than half of what the exercise is teaching, because the scores tell you what to trust rather than what to believe.

Work the mechanics carefully because the assignment specifies them. Each domain gets its own table cell, in the format shown in the manual. Each item is rated on the seven-point scale, and the domain score is a scaled percentage computed from the sum of item scores against the maximum and minimum possible — that calculation is prescribed in the manual and is a common place to lose marks by improvising an average instead. Comments are required on every rating, and this is where the marks concentrate: an item scored three needs a sentence saying what was missing from the guideline document, with the source cited. The overall assessment then asks for a recommendation about use, and the honest answer is often yes with conditions — the development was sound but applicability was not addressed, or the evidence is strong but editorial independence was not declared. Say which domain drove your verdict.

Likely learning objectives

Inferred from the brief — check these against your own rubric.

  • 01
    Distinguish appraisal of development rigour from agreement with recommendations.
  • 02
    Apply a structured instrument across six domains.
  • 03
    Compute domain scores as the manual prescribes.
  • 04
    Reach a use recommendation traceable to a specific domain.
Assignment instructionsQuoted verbatim

Read the full question

Review every instruction before using the planning guidance that follows.

Details: While there are several tools to critically appraise practice guidelines, the most comprehensively validated appraisal tool is the AGREE II Instrument. The AGREE II Instrument can be used by individual practitioners to critically appraise health guidelines and by decision makers to inform policy decisions. The purpose of the AGREE II Instrument is to provide a framework to: Assess the quality of guidelines. Provide a methodological strategy for the development of guidelines. Inform what information and how the information ought to be reported in guidelines. Overall assessment includes rating the overall quality of the guideline and whether the guideline would be recommended for use in practice. Items are rated on a 7-point scale from 1 (Strongly Disagree) to 7 (Strongly Agree). A score of 1 is given when there is no information on that item or if it is poorly reported. A score of 7 is given if the quality of reporting is excellent and when full criteria have been met (Score explanations found in the AGREE II-GRS Instrument). A quality score is calculated for each of the six domains, which are independently scored. Domain scores are calculated by summing up all the scores of the items in the domain and by scaling the total as a percentage of the maximum possible score for that specific domain. For this assignment, you will choose a guideline and assess the overall quality and whether the guideline would be recommended for use in practice. DNP 820 Week 3 Critical Appraisal of Practice Guidelines General Requirements: Use the following information to ensure successful completion of this assignment: Download the AGREE II instrument. Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the expectations for successful completion. You are not required to submit this assignment to LopesWrite. Directions: Perform the following tasks to complete this assignment: Using the AGREE II instrument as your guide, create a table that discusses a practice guideline in which you might have questioned the recommendations. (Note: You may be able to copy and paste the instrument into a new Word document and complete the information.) Each domain must have its own cell (similar to the one shown in the manual) and add domain scores and an overall guideline assessment. Be sure to include comments and additional considerations that influenced your rating decision and cite any sources used. Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the learner, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper: Practice Hours Completion Statement DNP-820 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor. Critical Appraisal of Practice Guidelines
02

Turn the brief into deliverables

  1. 01
    A named practice guideline you have reason to question.
  2. 02
    A table with each AGREE II domain in its own cell.
  3. 03
    Domain scores calculated as the manual specifies.
  4. 04
    Comments justifying each rating, with sources cited.
  5. 05
    An overall assessment and recommendation about use.
03

Choose, score by domain, then recommend

01

The guideline and your doubt

Name the guideline and say what made you question it.

02

Domains one to three

Rate scope and purpose, stakeholder involvement and rigour of development.

03

Domains four to six

Rate clarity, applicability and editorial independence.

04

Scores and recommendation

Compute domain scores and give an overall assessment with conditions.

04

The instrument's own manual, first

Recommended databases

  • AGREE Enterprise
  • Guideline developer websites
  • PubMed Central
  • CINAHL

Search sequence

  1. 1.
    Download the AGREE II instrument and read the scoring section before rating anything.
  2. 2.
    Obtain the full guideline document, not a summary, since rigour items depend on the methods section.
  3. 3.
    Check whether the guideline reports its search strategy and conflict of interest declarations.
  4. 4.
    Look for a published AGREE II appraisal to see how comments are written.
05

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Nothing here is cleared for citation until you have read it.

  1. 01

    AGREE II | AGREE Enterprise website

    AGREE Enterprise · 2024

    The instrument and its manual, including the scaled domain score calculation the assignment requires.

  2. 02

    Clinical Practice Guidelines We Can Trust - NCBI Bookshelf

    Institute of Medicine (NCBI Bookshelf) · 2011

    The standards a trustworthy guideline is expected to meet, which is the substance behind the rigour domain.

  3. 03

    The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

    BMJ · 2021

    Reporting standards for the evidence synthesis a guideline should rest on, useful for judging rigour of development.

  4. 04

    The hierarchy of evidence: levels and grades of recommendation

    Indian Journal of Orthopaedics, via PubMed Central · 2010

    How evidence levels feed recommendation grades, which is what the rigour domain is checking for.

06

Review before submission

Common mistakes

  • Scoring the recommendations rather than the development process.
  • Averaging item scores instead of computing the scaled domain percentage.
  • Leaving comments blank on items scored in the middle of the range.
  • Choosing a guideline you have no view about, which makes the exercise mechanical.
  • Giving an overall verdict with no domain driving it.

Submission checklist

  • Did you appraise how the guideline was made, not whether you agree?
  • Does each domain have its own cell?
  • Are the domain scores computed the way the manual specifies?
  • Does every rating carry a comment?
  • Is the overall recommendation traceable to a domain?

Use this guide to plan and review your own work. Follow your institution's rules and read our academic-integrity policy.

Written by

Aaron Bishop

MA, Education

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Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.

Reviewed by

Dr. Nathan Cole

PhD, Rhetoric & Composition

Argumentation and thesis development

Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.

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