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Abstract
Background: the European Breast Guidelines on screening and diagnosis are evidence-based guidelines developed within the European Commission Initiative on Breast Cancer that aims to ensure the quality of care across Europe. They were developed by a multidisciplinary group (GDG) of experts in the field of screening and diagnosis of breast cancer, as well as patients, using the GRADE approach, including the use of Evidence to Decision frameworks. An updating strategy was developed and piloted to ensure they keep providing up-to-date recommendations.
Objectives: to present the results of the piloting of the updating strategy for the European Breast Guidelines.
Methods: the workflow of the updating strategy was based on the results of a systematic review on guidelines updating experiences/methods. The strategy was then piloted on a convenient sample of seven healthcare questions (HQs) (Figure 1). For each step of the process, specific tools were identified (Figure 2) and information about time for completion, understandability and easiness to rate was collected using a 5-point Likert scale (1 very easy to understand/rate; 5 very difficult).
Results: we piloted the updating process, starting in March 2018, on seven HQs selected by the GDG based on criteria like time of the searches and rapidly evolving topic. We judged three HQs as not needing update during the Prioritisation phase, the same happened to another two during the Surveillance phase (Figure 3). Finally, two HQs completed the Updating phase by November 2018 and we modified both. Only a small part of the GDG took part in the exercise ranging from 11 to 5 out of 27 members depending on the phase. The UpPriority tool (Prioritisation) mean score for understandability was 2.65 (range 1 to 5), and for easiness to rate was 2.75 (1 to 5); mean completion time in minutes for each HQ was 5.2 (1 to 15). For the Surveillance Questionnaire (Surveillance), the mean scores for understandability and easiness to rate were both 1.78 (1 to 4), and the mean completion time in minutes for each HQ was 15.33 (3 to 30).
Conclusions: the piloting served to highlight challenges and strengths of the updating strategy. The tools used were judged positively for understandability and easiness to rate. Possible limitations are: 1) the preselection of seven HQs may have undermined the role of the Prioritisation phase; 2) just a minority of the GDG members participated. We will use the results of the piloting to revise the strategy that will be then constantly applied to the European Breast Guidelines to keep them updated. Future developments of the strategy include the identification of the best and sustainable life cycle for the European Breast Guidelines i.e. living-guidelines, two-year time-lapse.
Patient or healthcare consumer involvement: three patient members of the GDG are involved in the entire guideline development process, including updating.
Objectives: to present the results of the piloting of the updating strategy for the European Breast Guidelines.
Methods: the workflow of the updating strategy was based on the results of a systematic review on guidelines updating experiences/methods. The strategy was then piloted on a convenient sample of seven healthcare questions (HQs) (Figure 1). For each step of the process, specific tools were identified (Figure 2) and information about time for completion, understandability and easiness to rate was collected using a 5-point Likert scale (1 very easy to understand/rate; 5 very difficult).
Results: we piloted the updating process, starting in March 2018, on seven HQs selected by the GDG based on criteria like time of the searches and rapidly evolving topic. We judged three HQs as not needing update during the Prioritisation phase, the same happened to another two during the Surveillance phase (Figure 3). Finally, two HQs completed the Updating phase by November 2018 and we modified both. Only a small part of the GDG took part in the exercise ranging from 11 to 5 out of 27 members depending on the phase. The UpPriority tool (Prioritisation) mean score for understandability was 2.65 (range 1 to 5), and for easiness to rate was 2.75 (1 to 5); mean completion time in minutes for each HQ was 5.2 (1 to 15). For the Surveillance Questionnaire (Surveillance), the mean scores for understandability and easiness to rate were both 1.78 (1 to 4), and the mean completion time in minutes for each HQ was 15.33 (3 to 30).
Conclusions: the piloting served to highlight challenges and strengths of the updating strategy. The tools used were judged positively for understandability and easiness to rate. Possible limitations are: 1) the preselection of seven HQs may have undermined the role of the Prioritisation phase; 2) just a minority of the GDG members participated. We will use the results of the piloting to revise the strategy that will be then constantly applied to the European Breast Guidelines to keep them updated. Future developments of the strategy include the identification of the best and sustainable life cycle for the European Breast Guidelines i.e. living-guidelines, two-year time-lapse.
Patient or healthcare consumer involvement: three patient members of the GDG are involved in the entire guideline development process, including updating.
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