Published 2 February 2009, doi:10.1136/bmj.b407
Cite this as: BMJ 2009;338:b407

Letters

Conflicting recommendations

Let’s not forget AGREE

The first 150 words of the full text of this article appear below.

Clinicians should have criteria to determine whether a guideline has been developed systematically and transparently, and we are surprised that Oxman and colleagues did not mention the appraisal of guidelines research and evaluation (AGREE) instrument.1 It was developed by an international collaboration of researchers and guideline developers and was validated on 100 guidelines from 11 countries.2 Recognised as the gold standard for assessing the quality of clinical guidelines, it has been translated in 20 languages, used by many guidelines developers around the world, and quoted in many peer reviewed articles.

A new critical appraisal tool for guidelines is not needed,3 but researchers should continue to improve the AGREE instrument and build on its existing foundations. For example, the AGREE Next Steps Collaboration has been established to improve the measurement properties of the instrument to enable clinicians to better discriminate between valid and invalid recommendations.

Cite this as: BMJ 2009;338:b407

Françoise Cluzeau, lecturer1, On behalf of the AGREE Research Trust

1 St George’s, University of London, London SW17 0RE

cluzeau@sgul.ac.uk

Competing . . . [Full text of this article]


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What should clinicians do when faced with conflicting recommendations?
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