Evidence synthesis summary formats for clinical guideline development group members: a mixed-methods systematic review protocol

Abstract

Introduction: Evidence syntheses, often in the form of systematic reviews, are essential for clinical guideline development and informing changes to health policies. However, clinical guideline development groups (CGDG) are multidisciplinary, and participants such as policymakers, healthcare professionals and patient representatives can face obstacles when trying to understand and use evidence synthesis findings. Summary formats to communicate the results of evidence syntheses have become increasingly common, but it is currently unclear which format is most effective for different stakeholders. This mixed-methods systematic review (MMSR) evaluates the effectiveness and acceptability of different evidence synthesis summary formats for CGDG members. Methods: This protocol follows guidance from the Joanna Briggs Institute on MMSRs and is reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA)-P guideline. A comprehensive search of six databases will be performed with no language restrictions. Primary outcomes are those relating to the effectiveness and preferences for and attitudes towards the different summary formats. We will include qualitative research and randomised controlled trials. Two reviewers will perform title, abstract, and full-text screening. Independent double-extraction of study characteristics and critical appraisal items will be undertaken using a standardised form. We will use a convergent segregated approach to analyse quantitative and qualitative data separately; results will then be integrated. Discussion: The results of this systematic review will provide an overview of the effectiveness and acceptability of different summary formats for evidence synthesis findings. These findings can be helpful for those in or communicating to guideline development groups. The results can also inform the development and pilot-testing of summary formats for evidence summaries.

Co-design workshops to develop evidence synthesis summary formats for use by clinical guideline development groups

“…Our focus group workshops allowed us to create a more practical list of recommendations that was co-designed with multidisciplinary clinical guideline development group members who use and create evidence synthesis summaries for decision-making. Our study's findings largely confirmed the 94 MMSR recommendations [8] and condensed them into more practical guidance containing 21 items. The guidance for summary producers generated from this research, emphasizes a "less-is-more" approach that avoids academic technical language, limits methodological information, and highlights the key conclusions or recommendations framed within the appropriate context.…”

“…This list has been co-created in collaboration with members of multidisciplinary clinical guideline development groups, who are well-versed in using and creating evidence synthesis summaries to aid decision-making. Our practical guidance of 21 items aligns with and has streamlined the 94 MMSR recommendations [8]. As we move forward, we intend to develop and user-test the prototype templates through detailed oneon-one semi-structured interviews.…”

“…We recently conducted a mixed methods systematic review (MMSR) [8,9] to identify the most effective and acceptable summary format(s) for different end-users involved in clinical GDGs. Our review findings covered a range of types of evidence syntheses, end-users, and summary formats.…”

Clinical practice guideline recommendations for pediatric solid organ injury care: A Systematic Review

“…This may reflect heterogeneity in development methods that could be addressed by rigorously using the GRADE evidence-to-decision framework, AGREE guidelines, and evidence synthesis summary formats to collate evidence. 32 Good In pediatric patients with blunt renal trauma, we strongly recommend routine blood pressure checks on follow up to diagnose hypertension.…”

“…Despite relatively uniform ratings of low quality of evidence for abstracted recommendations, EAST/PTS systematically rated all recommendations as strong using the GRADE method, whereas WSES and APSA uniformly graded recommendations with low-quality evidence as weak. This may reflect heterogeneity in development methods that could be addressed by rigorously using the GRADE evidence-to-decision framework, AGREE guidelines, and evidence synthesis summary formats to collate evidence 32 . Good practice statements, developed using GRADE methodology, 33,34 are an interesting alternative to formal graded recommendations when no direct evidence is available.…”