Evidence map›Paper›PMID 29925394›Full record

ArticleHealth research policy and systems2018

Validity and usability testing of a health systems guidance appraisal tool, the AGREE-HS.

Melissa C Brouwers, Denis Ako-Arrey, Karen Spithoff, Marija Vukmirovic, Ivan D Florez, John N Lavis, Francoise Cluzeau, Govin Permanand, Xavier Bosch-Capblanch, Yaolong Chen and 1 more

Abstract readEvaluation StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Health research policy and systems, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Increasing the environmental sustainability of operating rooms in Canada: an evidence-informed guideline for policy.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Guideline
  2. Pooled it
  3. Pooled it
  4. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Article
  5. Article
  6. Article
  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Melissa C BrouwersMcMaster University, Juravinski Site, G2 Wing, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada. mbrouwer@mcmaster.ca.ORCID http://orcid.org/0000-0003-1332-7806
Denis Ako-ArreyMcMaster University, Juravinski Site, G2 Wing, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Karen SpithoffMcMaster University, Juravinski Site, G2 Wing, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Marija VukmirovicMcMaster University, Juravinski Site, G2 Wing, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Ivan D FlorezMcMaster University, Juravinski Site, G2 Wing, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
John N LavisMcMaster University, 1280 Main Street West MML-417, Hamilton, ON, L8S 4L8, Canada.
Francoise CluzeauImperial College London, St. Mary's Hospital (Room 1070, Queen Elizabeth the Mother Wing), Praed Street, London, W2 1NY, United Kingdom.
Govin PermanandThe London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, United Kingdom.
Xavier Bosch-CapblanchSwiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.
Yaolong ChenLanzhou University (Evidence Based Medicine Center), 222 Tianshui S Rd, Chengguan Qu, Lanzhou Shi, Gansu Sheng, China.
AGREE-HS Research Team

Funding

Canadian Institutes of Health Research 201309MOP-311155-KTR-CEBA-40598
6 · The paper itself

Abstract

backgroundHealth systems guidance (HSG) provides recommendations to address health systems challenges. No tools exist to inform HSG developers and users about the components of high quality HSG and to differentiate between HSG of varying quality. In response, we developed a tool to assist with the development, reporting and appraisal of HSG - the Appraisal of Guidelines for Research and Evaluation-Health Systems (AGREE-HS). This paper reports on the validity, usability and initial measurement properties of the AGREE-HS.

methodsTo establish face validity (Study 1), stakeholders completed a survey about the AGREE-HS and provided feedback on its content and structure. Revisions to the tool were made in response. To establish usability (Study 2), the revised tool was applied to 85 HSG documents and the appraisers provided feedback about their experiences via an online survey. An initial test of the revised tool's measurement properties, including internal consistency, inter-rater reliability and criterion validity, was conducted. Additional revisions to the tool were made in response.

resultsIn Study 1, the AGREE-HS Overview, User Manual, quality item content and structure, and overall assessment questions were rated favourably. Participants indicated that the AGREE-HS would be useful, feasible to use, and that they would apply it in their context. In Study 2, participants indicated that the quality items were easy to understand and apply, and the User Manual, usefulness and usability of the tool were rated favourably. Study 2 participants also indicated intentions to use the AGREE-HS.

conclusionsThe AGREE-HS comprises a User Manual, five quality items and two overall assessment questions. It is available at agreetrust.org.

Indexed as

Practice Guidelines as TopicBenchmarkingDelivery of Health CareHumansReproducibility of ResultsStakeholder ParticipationSurveys and QuestionnairesHealth policyHealth systemHealth systems guidanceQuality appraisal

Identifiers

PMID29925394
PMCPMC6011397

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.