gms | German Medical Science

Background: Despite the increasing number of clinical practice guidelines (CPGs) published, to date there has been little literature on systematic appraising clinical recommendations.

Objectives: This study aims to offer an insight on the development process of a systematic review of CPGs using SWOT analysis.

Methods: A preliminary brainstorming was run to identify ideas, focusing on major aspects rather than creating a list of every possible Strength, Weakness, Opportunity and Threat. Individual items were weighted and then added together. Each quadrant in the matrix resulted in a number, giving an Internal Factor Evaluation and an External Factor Evaluation (IFE and EFE matrix).

Results: Using an a priori defined methodological process and a comprehensive search strategy are likely the most relevant strengths, although these strict criteria could be seen as a weakness considering that some guidelines had to be excluded. Regarding opportunities, it could help to resolve conflicts within different guidelines and it brings the possibility to systematically synthesize CPGs. Yet this last opportunity can be threatened due to the important variations among different countries that might render difficult to apply recommendations widely. Overall, the balance tipped in favour of the dichotomy strengths-opportunities against threats-weaknesses.

Discussion: This SWOT analysis has helped us to better understand the challenge of systematic reviewing CPGs, by analysing what has been done right and where there is room for improvement for future work.

Implications for guideline developers/users: Guideline developers can benefit from the reflections obtained from this study when tackling a similar task.