Article type
Abstract
Background
Clinical practice guidance encompasses clinical policies, procedures, protocols and guidelines (PPPGs), all aimed at supporting decisions made by clinicians and patients regarding suitable healthcare. In 2015 the National Clinical Effectiveness Committee of Ireland published Standards for Clinical Practice Guidance, these were informed by a systematic review, an Expert Advisory Group, and feedback from public consultation. To support an update of the standards, we undertook a scoping review to identify recent innovations in guideline and clinical practice guidance development.
Methods
Key innovations were considered to be practices or tools that support PPPG development. We searched Medline, CINAHL, Cochrane Library, three grey literature databases and 29 guideline development organisations websites for methodological handbooks and peer-reviewed articles, from 2015 until May 2023. One reviewer extracted data while a second verified it. A narrative synthesis was conducted.
Results
Eight handbooks from guideline development organisations described four key innovations in current practice. These included living guidelines, rapid guidelines and rapid reviews, for use in times of an emergency or when new, critical evidence emerges that necessitates a recommendation change. Other innovations in practice included the GRADE-ADOLOPMENT approach for contextualisation of guidelines and GRADEpro guideline development tool.
Of 25 included peer-review articles, six described innovations which also included findings of an evaluation. These included automated approaches to citation retrieval; development of pragmatic search strategies to update guidelines; evidence/guideline translation (e.g., patient versions of guidelines); integration framework of multiple guidelines for patients with co-morbidities; standardised electronic template for PPPGs; and machine learning approaches for article screening in systematic reviews. Of the remaining 19 articles, examples of key innovations included the adaptation of guidelines, use of technology such as online platforms, decision trees to facilitate decision-making, consideration of qualitative evidence synthesis, and colloquial evidence and realist reviews in guideline development.
Conclusions
We identified a range of innovations in practice and across the peer-review literature which could support the development of guidelines and clinical practice guidance to ensure it reflects current best practices. However, evaluations of these innovations are limited and further research in this area is needed.
Clinical practice guidance encompasses clinical policies, procedures, protocols and guidelines (PPPGs), all aimed at supporting decisions made by clinicians and patients regarding suitable healthcare. In 2015 the National Clinical Effectiveness Committee of Ireland published Standards for Clinical Practice Guidance, these were informed by a systematic review, an Expert Advisory Group, and feedback from public consultation. To support an update of the standards, we undertook a scoping review to identify recent innovations in guideline and clinical practice guidance development.
Methods
Key innovations were considered to be practices or tools that support PPPG development. We searched Medline, CINAHL, Cochrane Library, three grey literature databases and 29 guideline development organisations websites for methodological handbooks and peer-reviewed articles, from 2015 until May 2023. One reviewer extracted data while a second verified it. A narrative synthesis was conducted.
Results
Eight handbooks from guideline development organisations described four key innovations in current practice. These included living guidelines, rapid guidelines and rapid reviews, for use in times of an emergency or when new, critical evidence emerges that necessitates a recommendation change. Other innovations in practice included the GRADE-ADOLOPMENT approach for contextualisation of guidelines and GRADEpro guideline development tool.
Of 25 included peer-review articles, six described innovations which also included findings of an evaluation. These included automated approaches to citation retrieval; development of pragmatic search strategies to update guidelines; evidence/guideline translation (e.g., patient versions of guidelines); integration framework of multiple guidelines for patients with co-morbidities; standardised electronic template for PPPGs; and machine learning approaches for article screening in systematic reviews. Of the remaining 19 articles, examples of key innovations included the adaptation of guidelines, use of technology such as online platforms, decision trees to facilitate decision-making, consideration of qualitative evidence synthesis, and colloquial evidence and realist reviews in guideline development.
Conclusions
We identified a range of innovations in practice and across the peer-review literature which could support the development of guidelines and clinical practice guidance to ensure it reflects current best practices. However, evaluations of these innovations are limited and further research in this area is needed.