Article
Developing scoring guide for the AGREE 2 instrument in Korea: a modified Delphi approach
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Published: | July 10, 2012 |
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Background: As Korean CPG has shorter history than western countries, practical application of AGREE instrument is quite challenging in Korea. Korean CPG developers are usually using the AGREE for adaptation process. We identified there are considerable differences in score grading between raters for the individual AGREE item and such difference is getting worse in AGREE 2.
Objectives: We tried to make a scoring guide which can reflect characteristics of the healthcare and socio-legal environments of Korea through a modified Delphi consensus process.
Methods: A focus group generated 92 draft scoring guides to 1, 3, 5 and 7 for each 23 AGREE 2 items. In each round of Delphi process, consensus was defined as > 70% agreement. We recruited 13 panels and two consensus rounds were executed.
Results: Consensus was made for 81 scoring guides in the first round, but not in AGREE item 2 (3), 4 (3 and 5), 5 (3), 11 (3), 12(3), 16 (3, 5 and 7), and 19 (5 and 7). Each panel proposed amendment opinion for the draft which they don't agree. Focus group summarized it and made 11 amendment scoring guides. In the second round, consensus was made for remaining 11 scoring guides.
Discussion and implications for guideline developers: Our believing about the AGREE instrument is not only an evaluation tool for CPGs but also a suggestion for good CPG. We believe the application of AGREE 2 in Korea is in a course of stabilization, the scoring guide we developed can be helpful to this.