gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

De nova or adapted guideline development: which method to choose?

Meeting Abstract

  • C. Harstall - Institute of Health Economics, Edmonton, Alberta, Canada
  • A. Scott - Institute of Health Economics, Edmonton, Alberta, Canada
  • C. Moga - Institute of Health Economics, Edmonton, Alberta, Canada
  • V. Dery - Institut national d'excellence en santé et en services sociaux (INESSS), Montreal, QC, Canada
  • L. Pinsonneault - Institut national d'excellence en santé et en services sociaux (INESSS), Montreal, QC, Canada
  • P. Dagenais - Institut national d'excellence en santé et en services sociaux (INESSS), Montreal, QC, Canada

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocPS04

DOI: 10.3205/12gin016, URN: urn:nbn:de:0183-12gin0162

Published: July 10, 2012

© 2012 Harstall et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Using best evidence to inform clinical practice is fundamental for maximizing health care benefits. Clinical practice guidelines (CPGs) are important tools for standardizing appropriate delivery of care. Increasingly, HTA agencies are becoming actively engaged in CPG activities and are seen as an integral player in multidisciplinary guideline development teams.

This panel will present two methodological approaches used by two provincial HTA agencies: a de novo process using GRADE and an adaptation process similar to ADAPTE. The GRADE approach is a transparent and explicit process that includes a comprehensive methodology for rating the quality of evidence and strength of recommendations, with a judgment component. The adaptation process takes advantage of existing high quality CPGs. It uses a rigorous and systematic approach to modify or endorse recommendations developed in one cultural and organizational setting to a different context after consideration of local circumstances and needs.

The panelists will share their experiences using the de novo and adaptation processes, from the set-up phase to the finalization of recommendations. Successful strategies, advantages, limitations, and challenges of using each of these approaches will be presented. Participants will be invited to engage in a lively discourse with the panelists. Main learnings include: what ingredients make a good CPG; what steps are required to preserve the integrity of the evidence-based recommendations; what is the feasibility and efficiency of each approach; what methodological expertise is needed; and what are the roles and responsibilities of the various stakeholders.