gms | German Medical Science

Background: The methods to update clinical practice guidelines (CPGs) improved by this time, although no standardised process has been established so far.

Objectives: 1) To conduct a systematic review of methods describing when and how to update CPGs, and 2) to develop a concept for updating CPGs.

Methods: We conducted a systematic search in MEDLINE, EMBASE, and Cochrane Methodology Database for methodological publications on updating CPGs. Guideline development manuals were identified via websites of guideline developing organisations. Information describing the development, application or comparison of methods for updating or assessing the need for updating CPGs was analysed. Using the information attained from the analysed records a concept for updating CPGs was developed.

Results: 4492 journal articles were screened, six articles met the criteria for inclusion. 46 manuals were included, six gave details to the stated updating methods. The focus of most of the included publications is rather on the assessment of the need to update CPGs than on the question how to update. The developed concept distinguishes a decision-making process on the type and scope of a scheduled update as well as an ongoing systematic monitoring of CPGs.

Discussion: Partial updating often makes more sense than updating the whole CPG as topics and recommendations differ in terms of the need for updating. The decision-making process on the type and scope of update will raise the cost initially, but overall savings are expected.

Implications for guideline developers: Guideline developers should implement a systematic updating procedure, including an ongoing monitoring system considering the nature of guideline topics and the own available capabilities.