A manual for prioritizing the topics of clinical practice guidelines for family physicians

Abstract

Background:Development of a manual or well-defined criterion for prioritizing the topics of clinical practice guidelines (CPGs) will help validate and organize this process evermore. This study was conducted to design an applicable manual that would prioritize the CPG topics for family physicians.Methods:This study was a multi-stage method using a qualitative approach that was conducted for the manual developing. The manual development process took place in four steps, as follows: Literature review, interviews with ten experts, preparing a list of criteria and determining its appropriateness by applying the RAND/UCLA Appropriateness method, and development of the final draft of the manual and pilot study.Results:Interview transcripts went under content analysis and were classified into eight main groups, 12 subgroups, and 85 themes. A comprehensive list consisting of fifty preliminary criteria were extracted. After summarizing and classifying the criteria, 12 appropriate criteria were evaluated using the RAND appropriateness method. Eventually, based on the literature review and our own results of the interview analysis, a manual consisting of five main sections and one clause on ethics was developed. Later, a pilot study was conducted on ten family physician topics, and prioritized by nine experts.Conclusions:The manual can be eyed as a tool ensuring the quality of the process of prioritizing CPG topics for family physicians, as it takes into account the issues involved in priority-setting. Selecting informed stakeholders for rating the criteria and ranking the topics was an issue that was greatly emphasized by the experts. Eventually, the application of this manual can be the first step toward systematizing the process of prioritizing CPG topics in the country.

Prioritization approaches in the development of health practice guidelines: a systematic review

“…The general characteristics of the 10 distinct approaches for prioritizing guideline topics described in the papers are reported in Table 1. Most of the papers (7 out of 10, 70%) focused on guidelines for clinical practice [12–14, 16–18, 20]; one paper proposed a prioritization approach that is applicable to the clinical, public health and health systems fields [8]; and the two remaining papers proposed prioritization approaches respectively for World Health Organization (WHO) healthcare recommendations [15] and for public health guidelines [19]. All of the identified prioritization approaches focused on prioritizing guideline topics; none on prioritizing guideline recommendation questions or outcomes.…”

“…)De novoReveiz, 2010 [17]Independent researchersGuideline developers within developing countriesClinicalTopicsDe novoAtkins, 2012 [18]Independent researchersGuideline developers in respiratory diseasesClinical, respiratory diseasesTopicsDe novoSchünemann, 2014 [8]Independent researchersGuideline developersClinical, Public health and Health systemsTopicsDe novoReddy, 2014 [19]Independent researchersNational Institute for Health and Care Excellence (NICE)Public healthTopic (e.g., sickle cell screening, substance misuse, water fluoridation, etc. )De novoMounesan, 2016 [20]Tehran University of Medical SciencesGuideline developersClinical, family medicineTopics (e.g., anemia, osteoporosis, indigestion/dyspepsia, pneumonia, etc. )De novo…”

“…Table 2 shows steps of the development process of each of the 10 included approaches for prioritizing guideline topics. The two steps most frequently reported to be used in the development process were: reviewing the grey literature (e.g., databases of guideline developing organizations) (9 out of 10, 90%) [8, 12–18, 20] and engaging various stakeholders (9 out of 10, 90%) [8, 12–17, 19, 20]. Patient and public involvement was reported to be used in the development of only one prioritization approach [14].…”

“…Patient and public involvement was reported to be used in the development of only one prioritization approach [14]. Conducting primary research was reported in the development of four out of the 10 approaches (40%) [12, 16, 17, 20]. The primary aim of conducting this type of research was to rate the importance of the suggested prioritization criteria and to assess the participants’ views regarding existing prioritization approaches in their respective organizations.…”

“…The primary aim of conducting this type of research was to rate the importance of the suggested prioritization criteria and to assess the participants’ views regarding existing prioritization approaches in their respective organizations. Two studies followed all of the steps in the development process and were thus the most comprehensive and detailed [17, 20].…”