Article type
Year
Abstract
Background: Since the 1990s, practice guidelines have became commonplace in all fields of medicine and surgery. Most evidence based (EB) guidelines have been developed in the larger high income countries, such as the US, UK, France, Canada and Australia. One explanation for this phenomenon is the expense and length of time required for the elaboration process. The time of development period of a guideline is usually between 12 and 30 months according to the specialty group.
However, smaller countries such as Belgium will also benefit from EB guidelines, though they may not wish to adopt directly an existing guideline from another country. In 2004, three Belgian universities in collaboration with the Belgian Health Care Knowledge Centre, who initiated and funded the project, developed, over nine months a national EB guideline for prenatal care.
Objectives: To provide details of a structured methodology by taking a shortcut for producing Belgian Guidelines for prenatal care in low risk pregnancy women.
Methods: A four-step strategy was evolved:
1. A systematic literature review was performed: using Medline, Embase and Ovid, but also the major antenatal care conference reports, and mainly the recommendations of the ANAES, ICSI, NICE and SOGC on the relevant topic. Direct literature research was restricted to two aspects: (i) updating the EB tables of the most recent (NICE) guidelines and (ii) search of Belgian publications and topics where the Belgian context seemed specific.
2. Present practice in Belgium was described through billings from the social security and interviews of care providers.
3. A consensus was achieved that where present care in Belgium was in agreement with recommendations in the guidelines evolved in other countries, this was to be supported.
4. Where Belgian practice seemed at large with evidence, consensus on acceptable recommendations was obtained through an expert group.
Results: Recommendations on schedule and content of antenatal care as well as a summary of the relevant literature have been produced.
Conclusions: By adapting already developed evidence based guidelines and taking into account the specific situation in Belgium, in a short time and with more efficiency, we developed the national guidelines for prenatal care.
However, smaller countries such as Belgium will also benefit from EB guidelines, though they may not wish to adopt directly an existing guideline from another country. In 2004, three Belgian universities in collaboration with the Belgian Health Care Knowledge Centre, who initiated and funded the project, developed, over nine months a national EB guideline for prenatal care.
Objectives: To provide details of a structured methodology by taking a shortcut for producing Belgian Guidelines for prenatal care in low risk pregnancy women.
Methods: A four-step strategy was evolved:
1. A systematic literature review was performed: using Medline, Embase and Ovid, but also the major antenatal care conference reports, and mainly the recommendations of the ANAES, ICSI, NICE and SOGC on the relevant topic. Direct literature research was restricted to two aspects: (i) updating the EB tables of the most recent (NICE) guidelines and (ii) search of Belgian publications and topics where the Belgian context seemed specific.
2. Present practice in Belgium was described through billings from the social security and interviews of care providers.
3. A consensus was achieved that where present care in Belgium was in agreement with recommendations in the guidelines evolved in other countries, this was to be supported.
4. Where Belgian practice seemed at large with evidence, consensus on acceptable recommendations was obtained through an expert group.
Results: Recommendations on schedule and content of antenatal care as well as a summary of the relevant literature have been produced.
Conclusions: By adapting already developed evidence based guidelines and taking into account the specific situation in Belgium, in a short time and with more efficiency, we developed the national guidelines for prenatal care.