Priority-based initiative for updating existing evidence-based clinical practice guidelines: the results of two iterations

Abstract

Assessment and prioritization of existing CPGs are effective ways of ensuring that resources are directed toward the upkeep of those that are relevant and of highest priority.

The implementation of prioritization exercises in the development and update of health practice guidelines: A scoping review

“…Fig 1 shows the study flow diagram summarizing the study selection process. Out of the 33,339 identified citations, twelve papers met our inclusion criteria [14][15][16][17][18][19][25][26][27][28][29][30]. We excluded 896 articles based on full text screening for the following reasons: not a paper type of interest (n = 49); not describing a reproducible prioritization exercise (n = 322); not about health practice guidelines (n = 525).…”

“…One prioritization exercise was conducted in 1998 while the remaining ones were conducted between 2010 and 2017. Half of the prioritization exercises were implemented at a national level (n = 6) [14,16,19,27,29,30], while the rest were implemented at regional (n = 3) [25,26,28], provincial (n = 2) [15,18], or international levels (n = 1) [17]. All of the prioritization exercises focused on prioritizing guideline topics (as opposed to prioritizing questions or outcomes) and addressed clinical topics.…”

“…While three exercises focused on updating guidelines [14,15,26], nine focused on de novo development [16-19, 25, 27-30], and none addressed adaptation of guidelines. Funding sources were mainly professional societies (n = 5) [16,25,26,28,29] or public funding (n = 4) [15,18,19,30]. We present below our findings summarized as the steps of prioritization, with a focus on two of those steps for which detailed information was available (namely the generation of initial list of topics and prioritization criteria).…”

“…With the growing interest among researchers in prioritizing topics for the de novo development, update and adaptation of guidelines, several exercises have been conducted to yield explicit and transparent prioritization [15][16][17]. Some investigators relied primarily on the use of criteria to select priority guideline topics [18], while others have followed multicomponent prioritization processes and have used established tools and approaches [19].…”

Reporting Items for Updated Clinical Guidelines: Checklist for the Reporting of Updated Guidelines (CheckUp)

“…Updating clinical guidelines is a process that includes different stages: (1) prioritisation of candidate guidelines or recommendations to update [6], (2) identification of new scientific evidence [3,6–8], (3) assessment of the need to update [3,6,9], (4) updating the recommendations [6,10–12], and (5) publication of the updated guideline [6,13]. However, there is no consensus about what is the optimal methodology to operationalise each of these steps or how to report on the process [5,14,15,16]; the available guidance from guideline institutions is suboptimal [17,18].…”