Defining key questions for clinical practice guidelines: a novel approach for developing clinically relevant questions

Chakraborty, Samantha; Brijnath, Bianca; Dermentzis, Jacinta; Mazza, Danielle

doi:10.1186/s12961-020-00628-3

Cited by 14 publications

(10 citation statements)

References 36 publications

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“…9 A study on guideline development in Australia demonstrated the importance of end-user input to develop focused clinical questions that respond to clinical need. 37 Seminars in Reproductive Medicine © 2022. Thieme.…”

Section: Cpgs In Practicementioning

confidence: 99%

“…9 A study on guideline development in Australia demonstrated the importance of end-user input to develop focused clinical questions that respond to clinical need. 37 Such input can help focus evidence-based recommendations thereby increasing their relevance, acceptability, and feasible implementation in clinical practice. Given that the target population for PCC is all people of reproductive age, and that PCC is often delivered opportunistically across different levels of care and even social care, it is necessary to have comprehensive CPGs that answer clinical questions and promote collaboration and provision of high-quality and consistent care.…”

Section: Cpgs In Practicementioning

confidence: 99%

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A Systematic Review of Clinical Guidelines for Preconception Care

et al. 2022

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Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.

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Section: Cpgs In Practicementioning

confidence: 99%

Section: Cpgs In Practicementioning

confidence: 99%

A Systematic Review of Clinical Guidelines for Preconception Care

et al. 2022

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“…The scoping document includes the draft clinical/review questions and provides a clear and transparent structure to guide the GDG. 30 These questions consider efficacy, safety, quality of life, economic information and health services utilisation. The criteria for key review questions to be included in the scope are highlighted in box 1 .…”

Section: A Framework For Developing and Contextualising Guidelines Fo...mentioning

confidence: 99%

Ensuring quality in contextualised cancer management guidelines for resource-constraint settings: using a systematic approach

et al. 2022

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To address the wide variation in access to cancer care in India requires strengthening of infrastructure, trained oncology workforce, and minimisation of out-of-pocket expenditures. However, even with major investments, it is unlikely to achieve the same level of infrastructure and expertise across the country. Therefore, a resource stratified approach driven by evidence-based and contextualised clinical guidelines is the need of the hour. The National Cancer Grid has been at the forefront of delivery of standardised cancer care through several of its initiatives, including the resource-stratified guidelines. Development of new guidelines is resource and time intensive, which may not be feasible and can delay the implementation. Adaptation of the existing standard guidelines using the transparent and well-documented methodology with involvement of all stakeholders can be one of the most reasonable pathways. However, the adaptation should be done keeping in mind the context, resource availability, budget impact, investment needed for implementation and acceptability by clinicians, patients, policymakers, and other stakeholders. The present paper provides the framework for systematically developing guidelines through adaptation and contextualisation. The process can be used for other health conditions in resource-constraint settings.

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“…The source, number, and clarity of clinical questions in guidelines not only determine their recommendations but also have an impact on their dissemination and application, especially if the clinical questions have low relevance to frontline clinicians or the questions are poorly expressed 25 . Clinical questions can be obtained from the current literature (relevant guidelines, systematic reviews, or clinical studies) and from a survey of representative guideline users.…”

Section: Clinical Questionsmentioning

confidence: 99%