Rapid-review process to identify priorities for updating published guidelines

Article type
Authors
Stein A1, Kelly J2
1Scottish Intercollegiate Guideline Network
2Healthcare Improvement Scotland
Abstract
Background: Once published, guidelines can become outdated quickly and recommendations require re-evaluation against new evidence to remain valid and safe. SIGN guidelines are reviewed for update 3 years after publication. Scoping and review processes to identify whether new evidence may change existing recommendations can be labour-intensive and time-consuming.

Objectives: We sought to find a method of scoping which would be sufficiently thorough to provide confidence in results without the demands of a full review. We trialled a rapid-review process to provide an overview of new evidence without conducting exhaustive searches.

Methods: A rapid review was piloted with an existing guideline (SIGN 140: Management of primary cutaneous squamous cell carcinoma (SCC) to identify other recent guidelines, technology appraisals or systematic reviews related to the original key questions. Results from the new evidence were compared to the evidence in the guideline to check if further in-depth review was required.

The results of the review were summarised and circulated to the SCC guideline development group for consultation and to identify new developments not captured by the original guideline scope.

Results: For SCC a new systematic review reported no new robust evidence or changes in practice. The rapid review was considered to provide adequate information to decide that no changes were needed to the guideline.

The rapid review took around 2 days of literature searching and evaluation for a health services researcher, with some input from the guideline’s programme manager.

Conclusions: For this topic the rapid review at 3 years was a viable process to provide an objective overview of new evidence without being resource-intensive. Further testing is required for guideline topics which are likely to attract more fast-paced developments and randomised-controlled trials..