Reliability and validity of the AGREE instrument used by physical therapists in assessment of clinical practice guidelines
Identifieur interne : 007E97 ( Main/Exploration ); précédent : 007E96; suivant : 007E98Reliability and validity of the AGREE instrument used by physical therapists in assessment of clinical practice guidelines
Auteurs : Joy C. Macdermid [Canada] ; Dina Brooks [Canada] ; Sherra Solway [Canada] ; Sharon Switzer-Mcintyre [Canada] ; Lucie Brosseau [Canada] ; Ian D. Graham [Canada]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2005.
Abstract
The AGREE instrument has been validated for evaluating Clinical Practice Guidelines (CPG) pertaining to medical care. This study evaluated the reliability and validity of physical therapists using the AGREE to assess quality of CPGs relevant to physical therapy practice.
A total of 69 physical therapists participated and were classified as generalists, specialist or researchers. Pairs of appraisers within each category evaluated independently, a set of 6 CPG selected at random from a pool of 55 CPGs.
Reliability between pairs of appraisers indicated low to high reliability depending on the domain and number of appraisers (0.17–0.81 for single appraiser; 0.30–0.96 when score averaged across a pair of appraisers). The highest reliability was achieved for Rigour of Development, which exceeded ICC> 0.79, if scores from pairs of appraisers were pooled. Adding more than 3 appraisers did not consistently improve reliability. Appraiser type did not determine reliability scores. End-users, including study participants and a separate sample of 102 physical therapy students, found the AGREE useful to guide critical appraisal. The construct validity of the AGREE was supported in that expected differences on Rigour of Development domains were observed between expert panels versus those with no/uncertain expertise (differences of 10–21% p = 0.09–0.001). Factor analysis with varimax rotation, produced a 4-factor solution that was similar, although not in exact agreement with the AGREE Domains. Validity was also supported by the correlation observed (Kendall-tao = 0.69) between Overall Assessment and the Rigour of Development domain.
These findings suggest that the AGREE instrument is reliable and valid when used by physiotherapists to assess the quality of CPG pertaining to physical therapy health services.
Url:
DOI: 10.1186/1472-6963-5-18
PubMed: 15743522
PubMed Central: 555572
Affiliations:
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Macdermid</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Rehabilitation Science, McMaster University, Hamilton, Ontario</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, N6A 3A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, N6A 3A8</wicri:regionArea><wicri:noRegion>N6A 3A8</wicri:noRegion></affiliation></author><author><name sortKey="Brooks, Dina" sort="Brooks, Dina" uniqKey="Brooks D" first="Dina" last="Brooks">Dina Brooks</name><affiliation wicri:level="4"><nlm:aff id="I3">Department of Physical Therapy, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physical Therapy, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Solway, Sherra" sort="Solway, Sherra" uniqKey="Solway S" first="Sherra" last="Solway">Sherra Solway</name><affiliation wicri:level="4"><nlm:aff id="I3">Department of Physical Therapy, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physical Therapy, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Division of Clinical Decision-Making and Health Care, University Health Network, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Clinical Decision-Making and Health Care, University Health Network, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Switzer Mcintyre, Sharon" sort="Switzer Mcintyre, Sharon" uniqKey="Switzer Mcintyre S" first="Sharon" last="Switzer-Mcintyre">Sharon Switzer-Mcintyre</name><affiliation wicri:level="4"><nlm:aff id="I3">Department of Physical Therapy, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physical Therapy, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Brosseau, Lucie" sort="Brosseau, Lucie" uniqKey="Brosseau L" first="Lucie" last="Brosseau">Lucie Brosseau</name><affiliation wicri:level="1"><nlm:aff id="I5">School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa</wicri:regionArea><wicri:noRegion>University of Ottawa</wicri:noRegion></affiliation></author><author><name sortKey="Graham, Ian D" sort="Graham, Ian D" uniqKey="Graham I" first="Ian D" last="Graham">Ian D. 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Macdermid</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Rehabilitation Science, McMaster University, Hamilton, Ontario</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, N6A 3A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, N6A 3A8</wicri:regionArea><wicri:noRegion>N6A 3A8</wicri:noRegion></affiliation></author><author><name sortKey="Brooks, Dina" sort="Brooks, Dina" uniqKey="Brooks D" first="Dina" last="Brooks">Dina Brooks</name><affiliation wicri:level="4"><nlm:aff id="I3">Department of Physical Therapy, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physical Therapy, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Solway, Sherra" sort="Solway, Sherra" uniqKey="Solway S" first="Sherra" last="Solway">Sherra Solway</name><affiliation wicri:level="4"><nlm:aff id="I3">Department of Physical Therapy, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physical Therapy, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Division of Clinical Decision-Making and Health Care, University Health Network, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Clinical Decision-Making and Health Care, University Health Network, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Switzer Mcintyre, Sharon" sort="Switzer Mcintyre, Sharon" uniqKey="Switzer Mcintyre S" first="Sharon" last="Switzer-Mcintyre">Sharon Switzer-Mcintyre</name><affiliation wicri:level="4"><nlm:aff id="I3">Department of Physical Therapy, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physical Therapy, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Brosseau, Lucie" sort="Brosseau, Lucie" uniqKey="Brosseau L" first="Lucie" last="Brosseau">Lucie Brosseau</name><affiliation wicri:level="1"><nlm:aff id="I5">School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa</wicri:regionArea><wicri:noRegion>University of Ottawa</wicri:noRegion></affiliation></author><author><name sortKey="Graham, Ian D" sort="Graham, Ian D" uniqKey="Graham I" first="Ian D" last="Graham">Ian D. Graham</name><affiliation wicri:level="1"><nlm:aff id="I6">School of Nursing, University of Ottawa, Ottawa, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Nursing, University of Ottawa, Ottawa</wicri:regionArea><wicri:noRegion>Ottawa</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I7">Ottawa Health Research Institute, Ottawa, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ottawa Health Research Institute, Ottawa</wicri:regionArea><wicri:noRegion>Ottawa</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Health Services Research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The AGREE instrument has been validated for evaluating Clinical Practice Guidelines (CPG) pertaining to medical care. This study evaluated the reliability and validity of physical therapists using the AGREE to assess quality of CPGs relevant to physical therapy practice.</p></sec><sec sec-type="methods"><title>Methods</title><p>A total of 69 physical therapists participated and were classified as generalists, specialist or researchers. Pairs of appraisers within each category evaluated independently, a set of 6 CPG selected at random from a pool of 55 CPGs.</p></sec><sec><title>Results</title><p>Reliability between pairs of appraisers indicated low to high reliability depending on the domain and number of appraisers (0.17–0.81 for single appraiser; 0.30–0.96 when score averaged across a pair of appraisers). The highest reliability was achieved for Rigour of Development, which exceeded ICC> 0.79, if scores from pairs of appraisers were pooled. Adding more than 3 appraisers did not consistently improve reliability. Appraiser type did not determine reliability scores. End-users, including study participants and a separate sample of 102 physical therapy students, found the AGREE useful to guide critical appraisal. The construct validity of the AGREE was supported in that expected differences on Rigour of Development domains were observed between expert panels versus those with no/uncertain expertise (differences of 10–21% p = 0.09–0.001). Factor analysis with varimax rotation, produced a 4-factor solution that was similar, although not in exact agreement with the AGREE Domains. Validity was also supported by the correlation observed (Kendall-tao = 0.69) between Overall Assessment and the Rigour of Development domain.</p></sec><sec><title>Conclusion</title><p>These findings suggest that the AGREE instrument is reliable and valid when used by physiotherapists to assess the quality of CPG pertaining to physical therapy health services.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Hamilton (Ontario)</li><li>Toronto</li></settlement><orgName><li>Université McMaster</li><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Macdermid, Joy C" sort="Macdermid, Joy C" uniqKey="Macdermid J" first="Joy C" last="Macdermid">Joy C. Macdermid</name></region><name sortKey="Brooks, Dina" sort="Brooks, Dina" uniqKey="Brooks D" first="Dina" last="Brooks">Dina Brooks</name><name sortKey="Brosseau, Lucie" sort="Brosseau, Lucie" uniqKey="Brosseau L" first="Lucie" last="Brosseau">Lucie Brosseau</name><name sortKey="Graham, Ian D" sort="Graham, Ian D" uniqKey="Graham I" first="Ian D" last="Graham">Ian D. Graham</name><name sortKey="Graham, Ian D" sort="Graham, Ian D" uniqKey="Graham I" first="Ian D" last="Graham">Ian D. Graham</name><name sortKey="Macdermid, Joy C" sort="Macdermid, Joy C" uniqKey="Macdermid J" first="Joy C" last="Macdermid">Joy C. Macdermid</name><name sortKey="Solway, Sherra" sort="Solway, Sherra" uniqKey="Solway S" first="Sherra" last="Solway">Sherra Solway</name><name sortKey="Solway, Sherra" sort="Solway, Sherra" uniqKey="Solway S" first="Sherra" last="Solway">Sherra Solway</name><name sortKey="Switzer Mcintyre, Sharon" sort="Switzer Mcintyre, Sharon" uniqKey="Switzer Mcintyre S" first="Sharon" last="Switzer-Mcintyre">Sharon Switzer-Mcintyre</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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