Background: For a variety of reasons, policy makers and clinicians need rapid access to evidence-based decision support. The French National Authority for Health has developed accelerated guidelines (AG) according to a specific method, which is close to that specified in the G-I-N AG manual.

Objectives: To evaluate what evidence to search for and include in AG.

Methods: An experience-based feedback with three AG was performed.

Results: A context of urgency and a restricted number of questions are the common features of the three AG developed. Search strategies were executed in an iterative manner, starting with high-level evidence and, when this was not available, by progressively identifying lower level evidence on a case-by-case basis.
Different limitations were identified regarding the literature search. These were: insufficient guidelines available (indications of electrophoresis, serum proteins); outdated guidelines/systematic reviews (pain management in children); or specific topics which require extensive discussion (musculoskeletal disorders and burnout). These examples required a second search to refine search strategies and move to a lower level of evidence.

Conclusions: Our experience-based feedback concerning the development of 3 AG showed that high-level evidence is not always available and the process often requires a supplementary search on a case-by-case basis. The AG method includes stakeholder consultation phase which appears to be essential, especially when high-level evidence is not available.

Implications for guideline developers/user: The development of accelerated guidelines can be improved by better adjusted search literature.