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Various groups have developed tools related to guideline development and implementation. This page provides you with a sample of them. Please let us know if you feel that something is missing.

The GIN PUBLIC Toolkit

We are proud to present the ‘GIN PUBLIC Toolkit: Patient and Public Involvement in Guidelines’. The toolkit is the result of a series of consultation activities held by GIN PUBLIC at international conferences of the Guidelines International Network since 2008. These identified that guideline developers have a need for:

  • practical advice on developing effective patient and public involvement programs
  • clarified needs and expectations regarding such advice, and
  • explored common barriers and practical solutions for effective patient and public involvement in guidelines.              


The knowledge generated by these activities, the work and experience of GIN PUBLIC members and literature on the topic formed the basis for developing the toolkit.

Please note that the new chapters listed supersede those ones in the 2015 edition. 


Updates / New Chapters 2021

The AGREE Instrument

AGREEThe purpose of the Appraisal of Guidelines Research & Evaluation (AGREE) Instrument is to provide a framework for assessing the quality of clinical practice guidelines.

Developed in English, the AGREE instrument has now been translated into 22 languages. The AGREE II instrument, launched in 2010 to update to original instrument is also translated in several languages.

More information on AGREE and the Instrument as well as its translations is available on the AGREE Research Trust website:

The ADAPTE Manual and Resource Toolkit for guideline adaptation


The ADAPTE Collaboration has developed a systematic approach for the adaptation of guidelines produced for the use in one cultural and organisational context to be used in a different cultural and organisational context.

Guideline adaptation is the systematic approach to the endorsement and/or modification of a guideline(s) produced in one cultural and organisational setting for application in a different context. Adaptation may be used as an alternative to de novo guideline development, e.g., for customising (an) existing guideline(s) to suit the local context.


The ADAPTE Toolkit is freely available for use, however, charges may be levied by some organisations for use of their guideline, which may be subject to copyright.  It is the responsibility of the adapter to establish whether there will be a charge, when gaining permission from the original author.  GIN does not benefit from this in any way.

CheckUp: Checklist for the Reporting of Updated Guidelines

The Checklist for the Reporting of Updated Guidelines (CheckUp) has been published in PLoS Medicine. This has been the result of a partnership of the Iberoamerican Cochrane Centre (, the AGREE Collaboration (, and the GIN Updating Guidelines Working Group ( CheckUp can be used to evaluate the completeness of reporting in updated guidelines and as a tool to inform guideline developers about reporting requirements.

CheckUp was developed through a comprehensive process, including the use of systematic reviews,assessment of updated clinical guidelines, and engagement of the international guideline community through semi-structured interviews, a Delphi consensus survey, and an external review. Adherence to CheckUp will likely enhance the comprehensiveness and transparency of clinical guideline updating for the benefit of patients and the public, health care professionals, and other relevant stakeholders.

If you would like to find out more about CheckUp please do not hesitate to contact Robin Vernooij.

> Checklist

FLC - Critical Appraisal Tools Application


Critical appraisal tools have been developed by Basque Office for Health Technology Assessment, Ministry of Health from de Basque Government.

Osteba’s purpose is to promote the appropriate use of Healthcare Technologies in terms of safety, efficacy, accessibility and fairness, thereby providing the necessary information for making decisions. Efforts have therefore been made to optimize the working methods, both for bibliographical searches and the critical appraisal of the various designs of research projects for economic evaluation, identification and evaluation of emerging and obsolete technologies, as well as for recommending and preparing Clinical Practice Guidelines.

More details can be found by clicking on this link:

GLIA (Guideline Implementability Appraisal)

The objective of GLIA is to provide a tool for the appraisal of the implementability of clinical guidelines. Implementability refers to a set of guideline characteristics that predict potential challenges to effective implementation. In addition to a series of questions that inquire about global aspects of a guideline's implementability, the instrument explores 9 dimensions of individual recommendations.

A discussion of the development of GLIA has been published in BMC Medical Informatics and Decision Making at The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementation.

To obtain more information on the tool and a copy of the instrument, in Adobe PDF format, you will be asked to provide your name, institution, and email address on the following website:


GEM (Guideline Elements Model)

The Guideline Elements Model (GEM) is an XML- based guideline document model that can store and organise the heterogeneous information contained in practice guidelines. It is intended to facilitate translation of natural language guideline documents into a format that can be processed by computers.

GEM is intended to be used throughout the entire guideline lifecycle to model information pertaining to guideline development, dissemination, implementation, and maintenance. Information at both high and low levels of abstraction can be accommodated. Use of XML facilitates computer processing of the guideline information.

GEM II is constructed as a hierarchy of more than 100 elements with 10 major branches–Identity, Developer, Purpose, Intended Audience, Target Population, Method of Development, Testing, Revison Plan, Implementation Plan, and Knowledge Components.

The GEM II Schema was successfully balloted as an international standard for the representation of practice guidelines in XML format and has become ASTM standard E2210-06.

GIN / McMaster Guideline Checklist

MCMASTERIn September 2014, GIN and McMaster University entered into a partnership to jointly evolve and publish a Guideline Development Checklist.  The checklist is being produced for the benefit of guideline developers to ensure that no key steps are missed when developing a guideline.  Its use will support the development and implementation of trustworthy guidelines.  For further information and to find the online and pdf versions of the checklist, as well as a glossary of terms and tutorials, please visit the website click here

Translations of the GIN/McMaster checklists are available here:

Page last updated: Feb 25, 2021
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