Annette Kristiansen1, Linn Brandt2, Thomas Agoritsas3, Elie A Akl4, Eivind Berge5, Anne Flem Jacobsen6, Lars-Petter Granan7, Sigrun Halvorsen8, Gordon Guyatt9, Per Olav Vandvik10. 1. Department of Internal Medicine, Innlandet Hospital Trust, Gjøvik, Norway; Institute for Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Internal Medicine, Deaconess Hospital, Oslo, Norway. Electronic address: annettekrist@gmail.com. 2. Department of Internal Medicine, Innlandet Hospital Trust, Gjøvik, Norway; Institute for Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Internal Medicine, Deaconess Hospital, Oslo, Norway. 3. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. 4. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon. 5. Department of Internal Medicine, Oslo University Hospital, Ullevål, Oslo, Norway. 6. Department of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway. 7. Department of Physical Medicine and Rehabilitation, Department of Pain Management and Research, Oslo University Hospital, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway. 8. Division of Emergencies and Critical Care, Department of Cardiology B, Oslo University Hospital, Oslo, Norway. 9. Department of Internal Medicine, Deaconess Hospital, Oslo, Norway. 10. Department of Internal Medicine, Innlandet Hospital Trust, Gjøvik, Norway; Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
Abstract
BACKGROUND: The Antithrombotic Therapy and the Prevention of Thrombosis, 9th Edition: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (AT9) represent trustworthy international guidelines for antithrombotic treatment and thromboprophylaxis. We describe major changes to the format and content resulting from applying new strategies for guideline adaptation and dissemination. METHODS: A Norwegian guideline panel of 46 experts completed a structured and systematic adaptation process, updated the recommendations based on new evidence, and rewrote the recommendations in an electronic multilayered presentation format. We published the adapted guideline using the web-based Making GRADE the Irresistible Choice Guideline Authoring and Publication Platform. RESULTS: We applied a novel presentation format to 333 recommendations from 11 of the 15 management chapters in AT9 and condensed and restructured them into 249 recommendations in a multilayered format. We added additional relevant information, such as 29 best-practice statements about new oral anticoagulants and practical information sections for 121 recommendations. Common reasons for modifications included feasibility of the recommendations in a national context, disagreement with applied baseline risk estimates, and reevaluation of the balance between the benefits and harms of interventions in relation to assumed typical patient preferences and values. The adapted guideline was published and disseminated online in November 2013. CONCLUSIONS: New strategies for adapting, updating, and disseminating trustworthy guidelines proved feasible and will provide Norwegian health-care professionals and patients with up-to-date guidance tailored to national circumstances.
BACKGROUND: The Antithrombotic Therapy and the Prevention of Thrombosis, 9th Edition: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (AT9) represent trustworthy international guidelines for antithrombotic treatment and thromboprophylaxis. We describe major changes to the format and content resulting from applying new strategies for guideline adaptation and dissemination. METHODS: A Norwegian guideline panel of 46 experts completed a structured and systematic adaptation process, updated the recommendations based on new evidence, and rewrote the recommendations in an electronic multilayered presentation format. We published the adapted guideline using the web-based Making GRADE the Irresistible Choice Guideline Authoring and Publication Platform. RESULTS: We applied a novel presentation format to 333 recommendations from 11 of the 15 management chapters in AT9 and condensed and restructured them into 249 recommendations in a multilayered format. We added additional relevant information, such as 29 best-practice statements about new oral anticoagulants and practical information sections for 121 recommendations. Common reasons for modifications included feasibility of the recommendations in a national context, disagreement with applied baseline risk estimates, and reevaluation of the balance between the benefits and harms of interventions in relation to assumed typical patient preferences and values. The adapted guideline was published and disseminated online in November 2013. CONCLUSIONS: New strategies for adapting, updating, and disseminating trustworthy guidelines proved feasible and will provide Norwegian health-care professionals and patients with up-to-date guidance tailored to national circumstances.
Authors: Thomas Agoritsas; Anja Fog Heen; Linn Brandt; Pablo Alonso-Coello; Annette Kristiansen; Elie A Akl; Ignacio Neumann; Kari Ao Tikkinen; Trudy van der Weijden; Glyn Elwyn; Victor M Montori; Gordon H Guyatt; Per Olav Vandvik Journal: BMJ Date: 2015-02-10
Authors: Rima A Abdul-Khalek; Andrea J Darzi; Mohammad W Godah; Lama Kilzar; Chantal Lakis; Arnav Agarwal; Elias Abou-Jaoude; Joerg J Meerpohl; Wojtek Wiercioch; Nancy Santesso; Hneine Brax; Holger Schünemann; Elie A Akl Journal: J Glob Health Date: 2017-12 Impact factor: 4.413
Authors: Nicolas Delvaux; Stijn Van de Velde; Bert Aertgeerts; Martine Goossens; Benjamin Fauquert; Ilka Kunnamo; Paul Van Royen Journal: J Eval Clin Pract Date: 2015-08-07 Impact factor: 2.431
Authors: Linn Brandt; Per Olav Vandvik; Pablo Alonso-Coello; Elie A Akl; Judith Thornton; David Rigau; Katie Adams; Paul O'Connor; Gordon Guyatt; Annette Kristiansen Journal: BMJ Open Date: 2017-02-10 Impact factor: 2.692
Authors: Yang Song; Andrea Darzi; Monica Ballesteros; Laura Martínez García; Pablo Alonso-Coello; Thurayya Arayssi; Soumyadeep Bhaumik; Yaolong Chen; Francoise Cluzeau; Davina Ghersi; Paulina F Padilla; Etienne V Langlois; Holger J Schünemann; Robin W M Vernooij; Elie A Akl Journal: BMJ Open Date: 2019-09-24 Impact factor: 2.692
Authors: Eva Fuentes Camps; José Luis del Val García; Sergi Bellmunt Montoya; Sara Hmimina Hmimina; Efren Gómez Jabalera; Miguel Ángel Muñoz Pérez Journal: Aten Primaria Date: 2015-08-19 Impact factor: 1.137