Article type
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Abstract
Background: In addition to using many Cochrane systematic reviews (SRs), Kaiser Permanente (KP) has been developing its own SRs and Clinical Practice Guidelines (CPGs) since 2002. However, the methodology continues to evolve with new grading methodologies (e.g., GRADE) and an increase in the methodological rigor required to produce trustworthy SRs and CPGs (e.g., Cochrane MECIR and Institute of Medicine standards). To support this work, KP has developed a web-based Virtual Collaborative Workspace (VCW) to conduct and manage all of the activities required to produce high-quality SRs and CPGs.
Objectives: To demonstrate the potential efficiencies of the VCW in supporting development of high-quality SRs and CPGs.
Methods: The VCW was conceptualized as a virtual end-to-end workflow platform for evidence synthesis and guideline creation that includes the following functions: • Documenting clinical questions in PICO format • Conducting and documenting systematic literature searches • Critically appraising individual studies using the Cochrane Risk of Bias Tool • Storing extracted data, conducting and documenting meta-analyses • Implementing GRADE (e.g., producing Summaryof Findings Table) • Creating and/or exporting data, tables and graphs • Developing evidence summaries, rationale statements and recommendation statements.
Results: Transitioning to the VCW required KP to be more rigorous and transparent at all stages of SR and CPG development. The increased documentation and group decision-making increased the time required to develop SRs and CPGs. However, the process has led to stronger collaboration within the Clinical Lead Team and to more concise and clear final products.
Conclusions: The process for developing SRs and CPGs is increasing in complexity. As a result, SR and CPG developers have to develop and use more sophisticated tools to manage all of the required steps. The integration of all these tools into a single platform supports rigor and transparency, while maximizing efficiency.
Objectives: To demonstrate the potential efficiencies of the VCW in supporting development of high-quality SRs and CPGs.
Methods: The VCW was conceptualized as a virtual end-to-end workflow platform for evidence synthesis and guideline creation that includes the following functions: • Documenting clinical questions in PICO format • Conducting and documenting systematic literature searches • Critically appraising individual studies using the Cochrane Risk of Bias Tool • Storing extracted data, conducting and documenting meta-analyses • Implementing GRADE (e.g., producing Summaryof Findings Table) • Creating and/or exporting data, tables and graphs • Developing evidence summaries, rationale statements and recommendation statements.
Results: Transitioning to the VCW required KP to be more rigorous and transparent at all stages of SR and CPG development. The increased documentation and group decision-making increased the time required to develop SRs and CPGs. However, the process has led to stronger collaboration within the Clinical Lead Team and to more concise and clear final products.
Conclusions: The process for developing SRs and CPGs is increasing in complexity. As a result, SR and CPG developers have to develop and use more sophisticated tools to manage all of the required steps. The integration of all these tools into a single platform supports rigor and transparency, while maximizing efficiency.