Article

Guidelines for Guidelines: Are They Up to the Task? A Comparative Assessment of Clinical Practice Guideline Development Handbooks

Old Dominion University, United States of America
PLoS ONE (Impact Factor: 3.23). 11/2012; 7(11):e49864. DOI: 10.1371/journal.pone.0049864
Source: PubMed

ABSTRACT We conducted a comparative review of clinical practice guideline development handbooks. We aimed to identify the main guideline development tasks, assign weights to the importance of each task using expert opinions and identify the handbooks that provided a comprehensive coverage of the tasks.
We systematically searched and included handbooks published (in English language) by national, international or professional bodies responsible for evidenced-based guideline development. We reviewed the handbooks to identify the main guideline development tasks and scored each handbook for each task from 0 (the handbook did not mention the task) to 2 (the task suitably addressed and explained), and calculated a weighted score for each handbook. The tasks included in over 75% of the handbooks were considered as 'necessary' tasks.
Nineteen guideline development handbooks and twenty seven main tasks were identified. The guideline handbooks' weighted scores ranged from 100 to 220. Four handbooks scored over 80% of the maximum possible score, developed by the National Institute for Health and Clinical Excellence, Swiss Centre for International Health, Scottish Intercollegiate Guidelines Network and World Health Organization. Necessary tasks were: selecting the guideline topic, determining the guideline scope, identifying relevant existing guidelines, involving the consumers, forming guideline development group,, developing clinical questions, systematic search for evidence, selecting relevant evidence, appraising identifies research evidence, making group decision, grading available evidence, creating recommendations, final stakeholder consultation, guideline implementation strategies, updating recommendations and correcting potential errors.
Adequate details for evidence based development of guidelines were still lacking from many handbooks. The tasks relevant to ethical issues and piloting were missing in most handbooks. The findings help decision makers in identifying the necessary tasks for guideline development, provide an updated comparative list of guideline development handbooks, and provide a checklist to assess the comprehensiveness of guideline development processes.

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Available from: Arash Rashidian, Oct 20, 2014
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    • "In 2010, AGREE II was translated into Korean and distributed to Korean medical societies. The usefulness of AGREE II have been verified through various quality assessment studies of specific diseases (8, 9, 10, 11), international comparison of the level of guideline development (12, 13), and overall quality assessment of CPGs developed in specific countries (14, 15, 16, 17). "
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    Journal of Korean Medical Science 06/2014; 29(6):771-5. DOI:10.3346/jkms.2014.29.6.771 · 1.25 Impact Factor
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    • "In the last decade, guideline organizations faced new problems [1]. First, both guideline developers and implementation experts reported a lack of methodological support in producing high-quality guidelines and felt a need for specific tools to help them in improving the quality of the guidelines [3]. A second problem is that the development and updating of high-quality guidelines require substantial resources, while government is cutting back spending on guideline development. "
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    Implementation Science 03/2014; 9(1):34. DOI:10.1186/1748-5908-9-34 · 3.47 Impact Factor
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    • "A lack of compliance with state of the art methodology for developing CPGs has been found, and hence the methodological quality of CPGs remained very similar over the last two decades [17,18]. Little is known about the guidance for updating CPGs included in these handbooks [19,20]. Therefore, we systematically reviewed CPGs methodological handbooks to identify and describe the methodological guidance about updating. "
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