Shahnaz Sultan1, Madelin R Siedler2, Rebecca L Morgan3, Toju Ogunremi4, Philipp Dahm5, Lisa A Fatheree6, Thomas S D Getchius7, Pamela K Ginex8, Priya Jakhmola9, Emma McFarlane10, M Hassan Murad11, Robyn L Temple Smolkin12, Yasser S Amer13,14,15, Murad Alam16, Bianca Y Kang16, Yngve Falck-Ytter17, Reem A Mustafa3,18. 1. Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis VA Health Care System, Minneapolis, MN, USA. ssultan@umn.edu. 2. Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA. 3. Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 4. Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada. 5. Department of Urology, Minneapolis VA Health Care System, University of Minnesota, Minneapolis, MN, USA. 6. College of American Pathologists, Northfield, IL, USA. 7. Guideline Strategy and Operations, American Heart Association and American College of Cardiology, Dallas, TX, USA. 8. Evidence-Based Practice, Oncology Nursing Society, Pittsburgh, PA, USA. 9. U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA. 10. National Institute for Health and Care Excellence, Manchester, UK. 11. Evidence-based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA. 12. Association for Molecular Pathology, Rockville, MD, USA. 13. Pediatrics, Quality Management, King Saud University Medical City, Riyadh, Saudi Arabia. 14. Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia. 15. Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt. 16. Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 17. Gastroenterology Seection, VA Northeast Ohio Healthcare System, Case Western Reserve University, Cleveland, OH, USA. 18. Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
Abstract
BACKGROUND: The development of rigorous, high-quality clinical guidelines increases the need for resources and skilled personnel within guideline-producing organizations. While collaboration between organizations provides a unique opportunity to pool resources and save time and effort, the collaboration presents its own unique challenges. OBJECTIVE: To assess the perceived needs and current challenges of guideline producers worldwide related to guideline development and collaboration efforts. DESIGN: Survey questions were developed by the Guidelines International Network and the US GRADE Network, pilot-tested among attendees of a guideline development workshop, and disseminated electronically using convenience and snowball sampling methods. PARTICIPANTS: A total of 171 respondents representing 30 countries and more than 112 unique organizations were included in this analysis. MAIN MEASURES: The survey included free-response, multiple-choice, and seven-point Likert-scale questions. Questions assessed respondents' perceived value of guidelines, resource availability and needs, guideline development processes, and collaboration efforts of their organization. KEY RESULTS: Time required to develop high-quality systematic reviews and guidelines was the most relevant need (median=7; IQR=5.5-7). In-house resources to conduct literature searches (median=4; IQR=3-6) and the resources to develop rigorous guidelines rapidly (median=4; IQR=2-5) were perceived as the least available resources. Difficulties reconciling differences in guideline methodology (median=6; IQR=4-7) and the time required to establish collaborative agreements (median=6; IQR=5-6) were the most relevant barriers to collaboration between organizations. Results also indicated a general need for improvement in conflict of interest (COI) disclosure policies. CONCLUSION: The survey identified organizational challenges in supporting rigorous guideline development, including the time, resources, and personnel required. Connecting guideline developers to existing databases of high-quality systematic reviews and the use of freely available online platforms may facilitate guideline development. Guideline-producing organizations may also consider allocating resources to hiring or training personnel with expertise in systematic review methodologies or utilizing resources more effectively by establishing collaborations with other organizations.
BACKGROUND: The development of rigorous, high-quality clinical guidelines increases the need for resources and skilled personnel within guideline-producing organizations. While collaboration between organizations provides a unique opportunity to pool resources and save time and effort, the collaboration presents its own unique challenges. OBJECTIVE: To assess the perceived needs and current challenges of guideline producers worldwide related to guideline development and collaboration efforts. DESIGN: Survey questions were developed by the Guidelines International Network and the US GRADE Network, pilot-tested among attendees of a guideline development workshop, and disseminated electronically using convenience and snowball sampling methods. PARTICIPANTS: A total of 171 respondents representing 30 countries and more than 112 unique organizations were included in this analysis. MAIN MEASURES: The survey included free-response, multiple-choice, and seven-point Likert-scale questions. Questions assessed respondents' perceived value of guidelines, resource availability and needs, guideline development processes, and collaboration efforts of their organization. KEY RESULTS: Time required to develop high-quality systematic reviews and guidelines was the most relevant need (median=7; IQR=5.5-7). In-house resources to conduct literature searches (median=4; IQR=3-6) and the resources to develop rigorous guidelines rapidly (median=4; IQR=2-5) were perceived as the least available resources. Difficulties reconciling differences in guideline methodology (median=6; IQR=4-7) and the time required to establish collaborative agreements (median=6; IQR=5-6) were the most relevant barriers to collaboration between organizations. Results also indicated a general need for improvement in conflict of interest (COI) disclosure policies. CONCLUSION: The survey identified organizational challenges in supporting rigorous guideline development, including the time, resources, and personnel required. Connecting guideline developers to existing databases of high-quality systematic reviews and the use of freely available online platforms may facilitate guideline development. Guideline-producing organizations may also consider allocating resources to hiring or training personnel with expertise in systematic review methodologies or utilizing resources more effectively by establishing collaborations with other organizations.
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