Partnership in kidney health organizations leading to improvement in chronic kidney disease guidelines in Australia and New Zealand

Article type
Authors
Cashmore B1, Craig J2, Krishnasamy R3, Lee V4, Natale P5, Roberts I1, Stanley I6, Tunnicliffe D1
1Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
2Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, Flinders University, Adelaide, SA, Australia
3The University of Queensland, Brisbane, QLD, Australia; Department of Nephrology, Sunshine Coast Hospital, QLD, Australia
4Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia; Department of Renal Medicine, Westmead Hospital, Westmead, NSW, Australia
5The University of Bari, Bari, Italy
6The University of Queensland, Brisbane, QLD, Australia
Abstract
Background:
The slow processes of clinical guidelines are a barrier to evidence-based care. In chronic kidney disease, it is estimated that guidelines take 18 months to 3 years to develop, risking guidelines being inaccurate once published. The siloing of resources and expertise is often a barrier to the efficient development of clinical practice guidelines.

Objective:
We aim to describe the partnership between clinical trial networks, evidence synthesis organizations, and clinical guideline developers in kidney disease guidelines in Australia and New Zealand. We will identify the impact and innovation in guideline development that the partnership has led to.

Methods:
We used a descriptive document examining memorandums of understanding, correspondence, and minutes from meetings between partner organizations, Australasian Kidney Trials Network, Cochrane Kidney and Transplant, and Caring for Australians and New ZealandeRs with kidney Impairment (CARI) Guidelines. Additionally, we collated the trials, systematic reviews, and guidelines produced by the organizations following the mutual partnership. We performed a narrative synthesis of the collated data to summarize the impact of the translation of research evidence into clinical practice guidelines.

Results:
Since 2021, resources have been shared between scientific kidney organizations in Australia and New Zealand—for example, a study-based registry of all clinical trials in chronic kidney disease and published and in-development systematic reviews led by author teams worldwide. The collective expertise of clinical trialists and guideline developers from 20-year-old organizations has led to more diverse and engaged working groups. CARI Guidelines has developed 3 living guidelines (12 recommendations) over 12 months and 2 rapid (<6 months in development) guidelines (4 recommendations) on the basis of new clinical trials. Five Cochrane reviews have been published and 2 rapid reviews that updated existing high-quality (according to AMSTAR2) published systematic reviews that informed guideline development.

Conclusions:
The sharing of resources and expertise between like-minded organizations has resulted in dramatic improvement in developing clinical practice guidelines. The innovation has drastically increased the output and impact of chronic kidney disease clinical practice guidelines in Australia and New Zealand.