Article type
Abstract
Background
In order to remain relevant for primary care decision-making, clinical practice guidelines (CPGs) should reflect new and emerging evidence. The Belgian working group WOREL (Working Group Development of Primary Care Guidelines) has published 47 CPGs. It is essential (1) to identify the need to update a guideline or (a) specific recommendation(s), (2) to follow literature in the context of living guideline approaches, and (3) and to detect gaps in existing guidelines. Literature surveillance stands as a key element in sustaining this process.
Objective(s)
To describe the implementation of the literature surveillance methodology for CPGs and to evaluate its impact on the updating of recommendations and guidelines.
Methods
WOREL’s literature surveillance occurs through a collaborative effort from 2 partners: the Belgian Center for Pharmacotherapeutic Information and Minerva, an online journal focused on evidence-based practice, which disseminates preappraised studies in order to deliver independent and factual information.
WOREL's monitoring consists of a systematic screening of a predetermined set of sources (“Big Five” journals, drug bulletins, guideline developing organizations, journal clubs) as well as a database searching and monitoring by means of evidence alerts. Together these methods provide an automatic process to identify newly published evidence.
Relevant articles are categorized based on WOREL’s guidelines topics, the newsworthiness level (low, moderate, high) determined by factors like novelty, conflict with previous knowledge, and impact on health.
Results
The literature surveillance process is depicted in a flowchart that covers a 3-month screening period. The chart reports the following results for each step: in total, 185 relevant articles for the 47 guidelines, 12 articles confirming the recommendations, and 10 articles that are assessed with a moderate or high level of newsworthiness.
Additionally, the flowchart outlines decision points and actions to be taken.
Conclusion
During the initial implementation phase, criteria to assess the newsworthiness level had to be adjusted, particularly for articles unrelated to a clinical question or encountering conflicts with assessment criteria. Lastly, the decision to update a recommendation could be contingent upon a threshold of articles with a red level of newsworthiness.
In order to remain relevant for primary care decision-making, clinical practice guidelines (CPGs) should reflect new and emerging evidence. The Belgian working group WOREL (Working Group Development of Primary Care Guidelines) has published 47 CPGs. It is essential (1) to identify the need to update a guideline or (a) specific recommendation(s), (2) to follow literature in the context of living guideline approaches, and (3) and to detect gaps in existing guidelines. Literature surveillance stands as a key element in sustaining this process.
Objective(s)
To describe the implementation of the literature surveillance methodology for CPGs and to evaluate its impact on the updating of recommendations and guidelines.
Methods
WOREL’s literature surveillance occurs through a collaborative effort from 2 partners: the Belgian Center for Pharmacotherapeutic Information and Minerva, an online journal focused on evidence-based practice, which disseminates preappraised studies in order to deliver independent and factual information.
WOREL's monitoring consists of a systematic screening of a predetermined set of sources (“Big Five” journals, drug bulletins, guideline developing organizations, journal clubs) as well as a database searching and monitoring by means of evidence alerts. Together these methods provide an automatic process to identify newly published evidence.
Relevant articles are categorized based on WOREL’s guidelines topics, the newsworthiness level (low, moderate, high) determined by factors like novelty, conflict with previous knowledge, and impact on health.
Results
The literature surveillance process is depicted in a flowchart that covers a 3-month screening period. The chart reports the following results for each step: in total, 185 relevant articles for the 47 guidelines, 12 articles confirming the recommendations, and 10 articles that are assessed with a moderate or high level of newsworthiness.
Additionally, the flowchart outlines decision points and actions to be taken.
Conclusion
During the initial implementation phase, criteria to assess the newsworthiness level had to be adjusted, particularly for articles unrelated to a clinical question or encountering conflicts with assessment criteria. Lastly, the decision to update a recommendation could be contingent upon a threshold of articles with a red level of newsworthiness.