GHG is co-chair of the GRADE working group and chaired the executive of 9th iteration of the American College of Chest Physicians Antithrombotic Guidelines. Description of session and speaker topics Session will comprise 3 presentations (15 mins), one for each challenge, with 5 mins for questions of clarification then 30 mins of panel discussion. Background Developing guidelines to inform decisions regarding diagnostic tests presents unique challenges that are not encountered when addressing intervention questions. In many cases, diagnostic studies only provide test accuracy results and lack patient outcomes; outcomes that are typically sought to make recommendations. Objectives/Goal Using the lessons from our guideline group, the objectives of this workshop are for participants to learn practical skills related to the development of guidelines for diagnostic questions. Specifically, the following areas will be addressed: Generating an appropriate research question. Developing relevant eligibility criteria for choosing diagnostic studies. Critically appraising diagnostic studies using existing tools and quality criteria. Determining what types of recommendations can be generated when different types of evidence and information are available and to respond when the most relevant information is not available. Target Group, Suggested Audience Guideline developers or anyone interested in how to develop a guideline for diagnostic questions. Description of the Workshop and of the Methods used to Facilitate Interactions Using a problem-based educational approach, the workshop will begin with a quick review of the background information and objectives, and an illustrative example will be presented. Participants will then be guided through the steps of guideline development for diagnostic questions, and given problems in each step to consider and work through in small groups. Finally, participants will develop recommendations for one or two guidelines, based on evidence from diagnostic guideline projects we have completed in our guideline group.
INTERACTIVE WORKSHOPS 145WS EVIDENCE-BASED GUIDELINE DEVELOPMENT FOR
DIAGNOSTIC QUESTIONS
Background Evidence-based tools for symptom management were developed to assist healthcare providers in comprehensive assessment and appropriate management of symptoms. These evidence-based tools consist of comprehensive guides-to-practice, quick reference pocket guides, algorithms and smart phone apps. Objectives The symptom management tools promote an interdisciplinary model of care that enables early identification and assessment of symptoms, appropriate documentation and communication regarding symptoms, optimal symptom management, and coordinated care throughout the illness trajectory. The tools are intended to be user-friendly, and are available in print, web and smart phone applications. Methods The tools were developed by an interdisciplinary panel of healthcare providers using the ADAPTE guideline adaptation approach. This included a literature search for recent guidelines and systematic reviews, guideline appraisal using the AGREE tool and selection, and in some instances modification, of recommendations. Expert feedback was obtained and subsequently appropriate revisions were made. Results The symptom management tools provide recommendations based on the best available evidence and expert consensus, for assessing, determining aetiology, diagnosing potential problems and for recommending non-pharmacological and pharmacological interventions. Implications for Guideline Developers/Users The ADAPTE approach offers a comprehensive and rapid process of developing evidence-based tools for the cancer patient population. Following the global trend of creating user-friendly clinical guidance, the guides-to-practice, quick reference pocket guides, algorithms and smart phone apps are an innovative set of tools that are accessible to a diverse group of care providers, in a manner that would suit the individual's clinical needs.
Background To address the problem of sickness absence due to mental disorders, guidelines have been developed in various countries. Objectives To assess available guidelines on the management of mental disorders in an occupational health care setting on their quality and to compare recommendations. Methods Guidelines were selected by systematically searching PubMed, Guidelines International Network Library, and National Guideline Clearinghouse. In addition, members of the International Commission on Occupational Health were consulted. Quality of guidelines was assessed with the AGREEII instrument and recommendations were compared. Results Fifteen guidelines were included: 1 Japanese, 1 Danish, 2 Finnish, 2 South-Korean, 2 British and 7 Dutch. The quality of the guidelines varied. Barriers and facilitators for implementation (Applicability), competing interests (Editorial independences), and the process to gather and synthesise evidence (Rigour of Development) were poorest described. The domain Scope and Purpose scored highest. Recommendations concerning assessment refer to diagnostic classification, inventory of performance problems, causal factors and barriers for recovery. Specific workplace factors are often mentioned. Guidelines agree on work adaptation if necessary, psychological treatment and communication about treatment plan between involved actors. Discussion Guidelines are difficult to find since they are commonly exclusively available in local languages. Therefore probably more guidelines exist then found. To learn from each other, guidelines should be translated into world languages and be accessible via international databases. Implications Guideline developers can use AGREEII to increase quality. Although social context may differ among countries and can influence guideline recommendations, developers can learn from each other through reviews of this kind.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.