Evaluating a Practice Protocol

Take this opportunity to examine clinical guidelines or practice protocols from your specialty area.

Do the following  assignments:

Complete the protocol evaluation activity by following these instructions:

  1. Select a practice protocol related to your clinical setting. These may be from your agency’s policy and procedure manual used in your practice.
  2. Determine who wrote the protocol and request an interview with one or more individuals who were involved in developing the protocol. Interview questions may include, but are not limited to the following:
    1. Can you explain how protocols are developed in your agency?
    2. What specific information or data was used to develop this protocol?
    3. Are there any references you can identify that would give me a better understanding of the rationale for the practices used in the protocol?
    4. What rating system was used to critique the protocol guidelines?
  3. After the interview, categorize the sources of knowledge identified by the interviewee (e.g., authority, experience, research-based). Be specific.
  4. After the interview, you may not have enough information on which to rate the protocol. If, for example, the interviewee has not provided you with sources from the literature, you will have to do a search to determine whether research exists to support the protocol you are assessing. This does not have to be an exhaustive review, yet you should be able to determine whether there is valid research there to support your rating (see next step).
  5. Then, using the AGREE ll rating scale (see attached) , assess the protocol for its validity in application to practice.
  6. Complete a Brief Evaluation of the Protocol Outline by following these steps:
    1. Brief description of the protocol.
    2. Title and credentials of the individuals who developed the protocol.
    3. Parameters of the literature search and a summary of how the protocol was developed.
    4. Your summary conclusion about the types and quality of knowledge upon which the protocol was based with supporting rationale.
    5. A brief description of the AGREE rating scale used to assess the protocol.
    6. Your assessment of the validity of the selected protocol.
  7. Upload the following in the Assignment Dropbox:
    1. the Brief Evaluation (required elements listed below);
    2. the completed AGREE ll scale; and
    3. a copy of the clinical protocol in the designated Assignment Drop Box for this Module













The AGREE Next Steps Consortium
May 2009

UPDATE: September 2013






This document is the product of an international collaboration.
It may be reproduced and used for educational purposes,

quality assurance programmes and critical appraisal of
guidelines. It may not be used for commercial

purposes or product marketing. Approved non-English
language versions of the AGREE II Instrument must be used
where available. Offers of assistance in translation into other

languages are welcome, provided they conform to the
protocol set out by The AGREE Research Trust.


The AGREE II Instrument is a generic tool designed primarily to
help guideline developers and users assess the

methodological quality of guidelines.
The authors do not take responsibility for the improper use of

the AGREE II Instrument.

© The AGREE Research Trust, May 2009.
© The AGREE Research Trust, September 2013.

Brouwers M, Kho ME, Browman GP, Cluzeau F, feder G, Fervers B, Hanna S, Makarski J on behalf of the AGREE
Next Steps Consortium. AGREE II: Advancing guideline development, reporting and evaluation in healthcare. Can

Med Assoc J. Dec 2010, 182:E839-842; doi: 10.1503/cmaj.090449

The development of the AGREE II Instrument was funded by a

grant from the Canadian Institutes of Health Research (FRN77822)


AGREE II Project Office, [email protected]
AGREE Research Trust Web site,








Dr. Melissa C. Brouwers
Principal Investigator, AGREE Next Steps Consortium
McMaster University, Hamilton, Ontario, Canada

Consortium Members:
Dr. GP. Browman, British Columbia Cancer Agency, Vancouver Island, Canada
Dr. JS. Burgers, Dutch Institute for Healthcare Improvement CBO, The Netherlands
Dr. F. Cluzeau, Chair of AGREE Research Trust; St. George’s Hospital Medical School, London, UK
Dr. D. Davis, Association of American Medical Colleges, Wash