Article
Strategies for updating clinical practice guidelines: feasibility and efficiency
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Published: | July 10, 2012 |
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Outline
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Background: Little is known about the efficiency of search strategies to update Clinical Practice Guidelines (CPGs).
Objectives: To compare alternative search strategies with the standard exhaustive search.
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) from the CPGs National Program in Spain. A search strategy in McMasterPLUS (http://hiru.mcmaster.ca/hiru/HIRU_McMaster_PLUS_Projects.aspx), and a search strategy in MEDLINE trough PubMed Clinical Queries have been compared to an exhaustive search (gold standard). We will determine sensitivity, specificity, precision, and accuracy.
Results: We have: 1) Run the three search strategies; 2) Screened reference pertinence (according to the topic of interest, study design and publication type), 3) Matched the references with recommendations; 4) Surveyed clinicians and methodologists to check their relevance, and to identify key references (that modify a recommendation). Finally we will evaluate the level of agreement between the three search strategies.
Discussion: Traditional methods of updating through exhaustive search strategy are laborious and expensive. Alternative methods, such as highly sensitive and specific search filters, may help.
Implications for guidelines developers/users: Our results will inform guideline developers about the feasibility and efficiency of several search strategies to maintain the validity of CPGs. Our results could have major implications for a more efficient use of resources in the CPG arena.