gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Survival analysis of a cohort of Clinical Practice Guidelines from the Spanish National Guideline Programme

Meeting Abstract

  • L. Martínez García - Iberoamerican Cochrane Centre, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
  • P. Díaz del Campo - Agencia Laín Entralgo. Health Technology Assessment Unit (UETS), Madrid, Spain
  • M.D. Estrada - Catalan Agency for Health Information, Assessment and Quality (CAHIAQ), Barcelona, Spain
  • I. Etxeandia-Ikobaltzeta - OSTEBA - Basque Office for Health Technology Assessment, Vitoria, Spain
  • A. Louro González - Servicio Gallego de Salud (SERGAS), A Coruña, Spain
  • D. Rigau - Iberoamerican Cochrane Centre, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
  • F. Salcedo-Fernandez - GuíaSalud-Aragon Institute of Health Sciences, Zaragoza, Spain
  • M.D.M. Trujillo Martín - Fundación Canaria de Investigación y Salud (FUNCIS), Canary Islands, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
  • P. Alonso-Coello - Iberoamerican Cochrane Centre, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP043

DOI: 10.3205/12gin155, URN: urn:nbn:de:0183-12gin1558

Published: July 10, 2012

© 2012 Martínez García 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

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Background: Little is known about how frequently Clinical Practice Guidelines (CPGs) need to be updated.

Objectives: To provide empirical estimates of the average time for CPGs to become obsolete.

Methods: We have randomly selected a sample of recommendations from four CPGs (Management of Major Depression, Prevention and Treatment of Obesity, Prevention of Stroke, Prostate Cancer Treatment). We will perform a survival analysis (Kaplan-Meier method) and we will define the CPGs obsolescence when more than 20% recommendations need to be updated.

Results: We have developed a strategy to assess the validity of recommendations: 1) Identification of questions to be answered and recommendations for each CPGs; 2) Baseline survey to clinical experts about the validity of recommendations; 3) Update literature search with an exhaustive strategy; 4) Reference screening by pertinence (according to topic of interest, study design and publication type); 5) Matching pertinent references with recommendations; 6) Survey to clinical experts and methodologists for: the identification of relevant references (that could be use when considering the update of a recommendation), the identification of key references (that modify a recommendation) and the potential changes in the recommendation (population, intervention, comparison, outcome, quality of the evidence, direction and strength); 7) Final report with the status of each guideline.

Discussion: Our research will inform about the obsolescence of recommendations in four health care areas. So far only one study [Shekelle et al 2001] has evaluated this issue before.

Implications for guideline developers/users: Our results will inform guideline developers about the expected longevity of their guidelines.