gms | German Medical Science

Background: In the Netherlands there is no systematic national approach to prioritizing guideline topics. Mostly guideline development is initiated on an ad hoc basis. This could lead to important clinical topics being missed and limited funds spent inappropriately.

Objectives: To develop broadly accepted criteria for prioritizing guideline topics and to use these criteria to identify guideline topics with highest priority.

Methods: Sixty-three health care organizations were asked to participate, representing six health care sectors (professionals, patients, healthcare insurance companies umbrella organisations of hospitals etc.). Based on a literature review and comments of participating organizations, a longlist with potential prioritization criteria was formed. The importance of these criteria was assessed on a nominal scale using an online modified Delphi procedure (Synmind). From this a weight was calculated for each criterion. In a second Synmind procedure 300 topics for guideline development were scored for relevance with the top five prioritization criteria.

Results: The top five prioritization criteria were: ”Uncertainty among professionals about proper care”, “Severity of the condition”, “Possibility to improve quality of care”, “Patient safety” and “Incidence/prevalence”. Interestingly “costs” was not selected as a top five criterion. Overall this criterion was given a moderate weight, which did not vary among the different sectors.

Discussion: The project shows that it is possible to define broadly accepted criteria for a national prioritization strategy for guideline topics.

Implications: This list is expected to set a national agenda for guideline development and that the criteria may also be helpful for guideline prioritization in other countries.