Grant: Operating Grant

Practice guidelines (PGs) are systematically developed statements to help in decisions made by patients, clinicians and policy makers. In a previous grant, our team created the AGREE II, the revised international standard for PG development, reporting, and evaluation. While necessary it is not sufficient; the AGREE II does not specifically address the clinical credibility of the recommendations, which is important for their implementation. Our current AGREE A3 project focused specifically on PG recommendations. To date, we have designed the Recommendation EXcellence Framework (REX-F). It reflects five domains, 18 sub-domains and several attributes related to PG recommendation implementability. The five domains are Format, Feasibility, Language, Rigour of Development and Considered Judgment. Using established methods and the REX-F as a foundation, our objective is to create AGREE-REX, a resource to direct the development, reporting, and evaluation of clinically credible recommendations. The AGREE-REX will be comprised of an Assessment Tool, a User's Guide, and a toolkit of practical strategies called Resource-REX. An iterative three-stage process will be used to create the Assessment Tool and User's Guide so that reliability, validity and usability are established. A fourth stage will be used to create the toolkit of existing tools designed to facilitate the development of clinically credible recommendations. The deliverable of this project will be a scientifically sound and practical tool, AGREE-REX, that will direct the development, reporting and evaluation of clinical recommendations so that their credibility is optimized.