gms | German Medical Science

Background: We have been developing our own CPGs since 2002. However, the methodology for developing CPGs continues to evolve with new grading methodologies (e.g., GRADE) and an increase in the methodological rigor required to produce trustworthy CPGs (e.g., IOM standards).

Context: We engaged with an external technology vendor to develop a Virtual Collaborative Workspace (VCW) to conduct and manage all of the activities required to produce a high-quality CPGs. The VCW incorporates the GRADE system and either meets or exceeds IOM standards for the development of trustworthy CPGs. The VCW is a virtual end-to-end workflow platform for evidence synthesis and guideline creation that includes the following functions:

• Documenting the clinical question in PICO format
• Conducting and documenting systematic literature searches
• Critically appraising individual studies using the Cochrane Risk of Bias Tool
• Conducting and documenting meta-analyses
• Implementing GRADE (e.g., producing Summary of Findings Table)
• Populating and/or exporting data, tables and graphs into guideline templates
• Developing recommendation statements, rationale statements, and evidence summaries

Lessons for guideline developers: The process for developing guidelines is increasing in complexity requiring new organizational tools and processes to produce CPGs as efficiently as possible. As a result, guideline developers have to develop and use much more sophisticated tools to manage all of the steps required to investigate the clinical questions and produce the final guideline document.