gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Developing scoring guide for the AGREE 2 instrument in Korea: a modified Delphi approach

Meeting Abstract

  • Y.K. Lee - Laboratory Medicine and Genetics, Soonchunhyang University College of Medicine, Bucheon, Korea
  • E. Shin - Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
  • J.Y. Shim - Family Medicine, Gang-nam Severance Hospital, Yonsei University Health System, Seoul, Korea
  • K.J. Min - Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
  • J.M. Kim - Urology, Soonchunhyang University College of Medicine, Bucheon, Korea
  • S. Lee - Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP096

doi: 10.3205/12gin208, urn:nbn:de:0183-12gin2084

Published: July 10, 2012

© 2012 Lee et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



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.