Lecture 22 - developing guidelines Flashcards
what is SIGN?
SIGN developed evidenced based clinical practice guidelines. SIGN guidelines are derived from a systematic review of the scientific literature and are designed as a vehicle for accelerating the translation of new knowledge into action to meet our aim of reducing variation in practice and improving patient important outcomes
what are types of research use to design guidelines?
case reports, case matches studies, randomised controlled trials, meta-analysis and Cochran reviews
what is the SIGN process for guidelines ?
Selection of a topic
Guideline development group
Systematic literature review
Forming recommendations
Consultation and peer review
Presentation and dissemination
what is selection of a topic based on?
SIGN capacity
Area of clinical uncertainty
Effective proven treatments where mortality/morbidity can be reduced
Clinical priority areas
Perceived need for the guideline – network of relevant stakeholders
what do SIGN guidelines also consider in selection of a topic?
SIGN take NICE guideline development into account
Guideline Programme Advisory Group selects topics to be worked up to full proposal
Detailed guideline proposal form completed
Discussed at SIGN Council
Decision to proceed
Formation of Guideline Development Group
what experts does the guidelines development group include ?
Chair – usually a consultant
SIGN personnel
Patient representative
Pharmacist – usually nominated by the RPS in Scotland
General Practitioner(s)
Hospital doctors
Nurses
Therapists
Others as appropriate
describe the process of conducting a systematic literature review
papers identified. a defined search strategy is used. reproducible at different time
abstracts sifted by lead for the question and appears are sent to reviewers
Each paper is reviewed by two independent healthcare professionals
Standard paperwork completed
RCT
Review
Case Report
Formation of a considered judgement
what are 6 different mythology checklists that use when reading and assessing research papers?
Systematic reviews and meta-analyses
Randomised controlled trials
Cohort studies
Case-control studies
Diagnostic studies
Economic studies
describe the details the components of a checklist for evaluating meta-analyses.
The study addresses a clearly defined research question
A comprehensive literature search is carried out
The authors clearly state if or how they limited their review by publication type
The included and excluded studies are listed
The characteristics of the included studies are provided
The methodological quality of the included studies is assessed and documented
The scientific quality of the included studies was assessed appropriately
The likelihood of publication bias is assessed
Rate the overall methodological quality of the study
what are limitations to guidelines?
Research carried out today may influence a guideline in 5 – 10 years
time for rating, publicising, review of papers, publication of papers etc
