Article
Impact of different approaches to development and updating of perinatal clinical practice guidelines
Search Medline for
Authors
-
P. Middleton
- ARCH, Robinson Institute, The University of Adelaide, Adelaide, Australia
-
C. Crowther
- ARCH, Robinson Institute, The University of Adelaide, Adelaide, Australia
| Published: | July 10, 2012 |
|---|
Outline
Text
Introduction: There can be substantial differences in the scope, methods and recommendations of clinical practice guidelines (CPGs) on similar topics, including perinatal CPGs.
Objective: To compare the scope, use of evidence (particularly Cochrane reviews) and updating methods of 140 perinatal CPGs listed as current at the end of 2011.
Methods: We extracted updating methods, currency, use of Cochrane reviews from 9 WHO and 11 NICE clinical practice guidelines; 50 Royal College of Obstetricians and Gynecologists’ (RCOG) Greentop Guides and 70 American College of Obstetrics and Gynecology (ACOG) Practice Bulletins; and compared the content of similar recommendations between CPGs.
Results: Typical number of total references used per CPG ranged from under 100 for ACOG and RCOG, 30–200 for WHO and 100–1655 for NICE. ACOG had a median 10 recommendations per guideline, median 15 for RCOG, WHO ranged from 1–23; and NICE typically had over 100 recommendations per CPG. Updating methods ranged from affirmation without including new content (some ACOG); archiving and referring to NICE CPGs (some RCOG) and complete updating (some NICE). One quarter of CPGs had not been updated in the last five years. Cochrane reviews usually made up less than 10% of all CPG references. Differences in recommendations between CPGs on similar topics include hypertension in pregnancy, induction of labour and diabetes in pregnancy.
Conclusions: Perinatal CPGs frequently differ in their approach and methods. This sometimes manifests as different recommendations on similar topics, due to differences in scope, currency, updating methods, and ways that sources of evidence were used.
