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
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.
- 01Distinguish appraisal of development rigour from agreement with recommendations.
- 02Apply a structured instrument across six domains.
- 03Compute domain scores as the manual prescribes.
- 04Reach a use recommendation traceable to a specific domain.
Read the full question
Review every instruction before using the planning guidance that follows.
Turn the brief into deliverables
- 01A named practice guideline you have reason to question.
- 02A table with each AGREE II domain in its own cell.
- 03Domain scores calculated as the manual specifies.
- 04Comments justifying each rating, with sources cited.
- 05An overall assessment and recommendation about use.
Choose, score by domain, then recommend
The guideline and your doubt
Name the guideline and say what made you question it.
Domains one to three
Rate scope and purpose, stakeholder involvement and rigour of development.
Domains four to six
Rate clarity, applicability and editorial independence.
Scores and recommendation
Compute domain scores and give an overall assessment with conditions.
The instrument's own manual, first
Recommended databases
- AGREE Enterprise
- Guideline developer websites
- PubMed Central
- CINAHL
Search sequence
- 1.Download the AGREE II instrument and read the scoring section before rating anything.
- 2.Obtain the full guideline document, not a summary, since rigour items depend on the methods section.
- 3.Check whether the guideline reports its search strategy and conflict of interest declarations.
- 4.Look for a published AGREE II appraisal to see how comments are written.
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.
- 01
AGREE II | AGREE Enterprise website
AGREE Enterprise · 2024
The instrument and its manual, including the scaled domain score calculation the assignment requires.
- 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.
- 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.
- 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.
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
assignment interpretation and research-methods coaching across disciplines
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.