Artikel
Survival analysis of a cohort of Clinical Practice Guidelines from the Spanish National Guideline Programme
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Veröffentlicht: | 10. Juli 2012 |
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Gliederung
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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.