Article type
Abstract
"Background: Clinical practice guidelines (CPGs) are pivotal for informed healthcare decision-making, guiding patients and practitioners towards optimal care. Guideline development relies on consensus-based approaches, consolidating expert opinions to establish agreement. However, variability in consensus definitions and methodologies presents challenges to guideline standardization and quality assurance.
Objectives: This study aims to evaluate the current landscape of consensus methodology within guideline development manuals, seeking to identify commonalities, discrepancies, and areas for enhancement. The assessment is critical for advancing the transparency and reliability of clinical guidelines.
Methods: This systematic review, guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, conducted a comprehensive search across five databases and relevant medical association websites. The search covered studies published from the establishment of the databases until July 7, 2023. Eligible studies comprised guideline development manuals detailing consensus methods, published by medical associations, societies, and academic institutions. Duplicate publications and guidelines without accessible full texts were excluded. Data extraction and synthesis utilized a standardized form to capture guideline characteristics, consensus methodologies, panel composition, conflict of interest management, and patient involvement.
Results: Our final analysis included 77 guidance manuals or documents. Among these, 44 (57%) explicitly mentioned the adoption of formal consensus methods, with 34 (44%) providing detailed descriptions of the consensus process. Thirty-one (40%) described the consensus process for identifying clinical questions, while 24 (31%) outlined the process for making recommendations. Twenty-seven (35%) mentioned criteria for selecting panel members, and 45 (58%) emphasized the inclusion of patients in the panel. Fifteen (19%) mentioned criteria for achieving consensus, although these criteria varied widely. Nine (12%) emphasized the need for anonymity during voting. However, there was a lack of detailed descriptions regarding strategies for resolving disagreements, factors influencing consensus, and reporting.
Conclusions: This systematic review reveals that while over half of the guideline development manuals emphasize formal consensus methods, recommendations for their application vary across different manuals. There is currently a lack of detailed guidance on the application of consensus methods, highlighting the need for standardization and improvement in this area."
Objectives: This study aims to evaluate the current landscape of consensus methodology within guideline development manuals, seeking to identify commonalities, discrepancies, and areas for enhancement. The assessment is critical for advancing the transparency and reliability of clinical guidelines.
Methods: This systematic review, guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, conducted a comprehensive search across five databases and relevant medical association websites. The search covered studies published from the establishment of the databases until July 7, 2023. Eligible studies comprised guideline development manuals detailing consensus methods, published by medical associations, societies, and academic institutions. Duplicate publications and guidelines without accessible full texts were excluded. Data extraction and synthesis utilized a standardized form to capture guideline characteristics, consensus methodologies, panel composition, conflict of interest management, and patient involvement.
Results: Our final analysis included 77 guidance manuals or documents. Among these, 44 (57%) explicitly mentioned the adoption of formal consensus methods, with 34 (44%) providing detailed descriptions of the consensus process. Thirty-one (40%) described the consensus process for identifying clinical questions, while 24 (31%) outlined the process for making recommendations. Twenty-seven (35%) mentioned criteria for selecting panel members, and 45 (58%) emphasized the inclusion of patients in the panel. Fifteen (19%) mentioned criteria for achieving consensus, although these criteria varied widely. Nine (12%) emphasized the need for anonymity during voting. However, there was a lack of detailed descriptions regarding strategies for resolving disagreements, factors influencing consensus, and reporting.
Conclusions: This systematic review reveals that while over half of the guideline development manuals emphasize formal consensus methods, recommendations for their application vary across different manuals. There is currently a lack of detailed guidance on the application of consensus methods, highlighting the need for standardization and improvement in this area."