Library of risk of bias tools


Study design(s) targeted by the tool Guidelinesguidelines
Additional details on designs
Tool area Health
Link to the tool Link to AGREE tool


Primary publication AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Quality and Safety in Health Care 2003;12(1)
DOI 10.1136/qhc.12.1.18
Guidance document

None known – please contact us if you are aware of any evaluations that should be listed here.

Language English

Many – links available here:

Record last updated

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Related tools

A variety of tools related to AGREE, including AGREE extensions, have been developed to assist in the development, reporting and evaluation of practice guidelines and health system guidance are available at

Other publications

Burgers JS, Fervers B, Haugh M, Brouwers M, Browman G, Philip T, Cluzeau FA. International Assessment of the Quality of Clinical Practice Guidelines on Oncology Using the Appraisal of Guidelines and Research Evaluation Instrument. Journal of Clinical Oncology . 2004 22 2000-07. [Pubmed abstract]

Burgers JS, Grol R, Klazinga NS, Mäkelä M, Zaat J, for The AGREE Collaboration. Towards evidence-based clinical practice: an international survey of 18 clinical guideline programs. International Journal for Quality in Health Care 2003; 15(1): 31-45.[Pubmed abstract]

Burgers JS, Bailey JV, Klazinga NS, Van der Bij AK, Grol R, Feder G, for the AGREE Collaboration. Inside guidelines: comparative analysis of recommendations and evidence in diabetes guidelines from 13 countries. Diabetes Care 2002; 25(11): 1933-1939.[Pubmed abstract]

Key Criteria

Focuses on risk of bias, or makes a distinction between items that assess risk of bias and other aspects of study quality No
Offers a method to reach either a domain specific or overall assessment of risk of bias Yes
Tool development involving a range of stakeholders from different disciplines (e.g. methodologists, statisticians, clinicians) Yes
Avoids recommending use of summary numerical quality scores No