gms | German Medical Science

Background: Modern guideline methodology demands a rigorous, structured approach to evidence review and analysis. Previous systems relied on different software applications, none of which were designed for the specific demands of guideline development.

Context:The EAU has been producing guidelines on Urological practice for over 10 years. Internationally renowned experts in Urology and related disciplines are involved in producing 20 regularly updated guidelines on different aspects of Urological practice.

Description: This web based system has been developed to provide a user friendly, intuitive, comprehensive guideline tool. The on-line application covers the following aspects of guideline development:

• Onscreen access to the current guideline
• Creation of PICO (Patient, intervention, Comparator, Outcomes) descriptions to guide new literature searches
• Onscreen access to the original paper under review with one click access to show or hide the PDF
• Structured standard appraisal of papers using questions with drop-down response options, and 'tooltip' explanations
• Summaries of appraisals in clear, informative, automatically populated evidence tables
• A cumulative database of appraisals performed
• A meta-analysis facility with forest plot display

The system is fully web based to allow access from any computer and enhance collaboration between experts in different countries.

Lessons for guideline developers, adaptors, implementers and/or users : The system has significantly reduced the time taken to perform rigorous systematic reviews and meta-analysis. It provides a structured methodology which will enhance the validity and quality of future guidelines.