Article type
Abstract
Background: The Infection Prevention and Control (IPC) team under the World Health Organization (WHO) Health Emergencies Programme (WHE) identified a need to update multiple existing guidance documents on IPC for Ebola and Marburg disease and consolidate them under one guideline.
Objectives: To describe the processes of reconciling overlapping guidance documents and of prioritizing questions for the WHO guideline in question.
Methods: We first reconciled existing guidance documents using different methodologies. We extracted all actionable statements, clustered them into themes, and classified them based on the type of the actionable statement (ie, formal recommendations, good practice statements, and implementation considerations). We then generated recommendation questions using the PIC (Population, Intervention, Comparator) format. Lastly, we conducted a prioritization exercise, for which we used a scoring tool consisting of a 6-point rating scale for 5 prioritization criteria: (1) uncertainty or controversy about best practice, (2) unsatisfactory existing guidance, (3) potential for changing existing guidance, (4) impact of intervention on health outcomes, and (5) feasibility of intervention implementation. Contributors included the WHO secretariat, the steering group, the methodologists, and the guideline development group.
Results: The reconciliation exercise identified 18 questions suitable for development as formal recommendations for the prioritization exercise. Out of a maximum of 30, the average total priority score was 20.49 (SD = 1.27). The mean and range of scores for the prioritization criteria were as follows: 3.80 (2.65-4.41) for "uncertainty or controversy about best practice," 3.75 (3.00-4.24) for "unsatisfactory existing guidance," 4.10 (3.47-4.76) for "potential for changing existing guidance," 4.16 (3.47-4.76) for "impact of intervention on health outcomes," and 4.68 (3.82-5.12) for "feasibility of intervention implementation." We found high correlation between 3 prioritization criteria: "uncertainty or controversy about best practice," "unsatisfactory existing guidance," and "potential for changing existing guidance."
Conclusions: Our approach was feasible and efficient and may be useful for guideline projects where 2 or more guidance documents overlap and need to be updated.
Public and/or Consumer Involvement: At the time of this work, the patient representative in the guideline development group was unavailable and did not participate in the exercise.
Objectives: To describe the processes of reconciling overlapping guidance documents and of prioritizing questions for the WHO guideline in question.
Methods: We first reconciled existing guidance documents using different methodologies. We extracted all actionable statements, clustered them into themes, and classified them based on the type of the actionable statement (ie, formal recommendations, good practice statements, and implementation considerations). We then generated recommendation questions using the PIC (Population, Intervention, Comparator) format. Lastly, we conducted a prioritization exercise, for which we used a scoring tool consisting of a 6-point rating scale for 5 prioritization criteria: (1) uncertainty or controversy about best practice, (2) unsatisfactory existing guidance, (3) potential for changing existing guidance, (4) impact of intervention on health outcomes, and (5) feasibility of intervention implementation. Contributors included the WHO secretariat, the steering group, the methodologists, and the guideline development group.
Results: The reconciliation exercise identified 18 questions suitable for development as formal recommendations for the prioritization exercise. Out of a maximum of 30, the average total priority score was 20.49 (SD = 1.27). The mean and range of scores for the prioritization criteria were as follows: 3.80 (2.65-4.41) for "uncertainty or controversy about best practice," 3.75 (3.00-4.24) for "unsatisfactory existing guidance," 4.10 (3.47-4.76) for "potential for changing existing guidance," 4.16 (3.47-4.76) for "impact of intervention on health outcomes," and 4.68 (3.82-5.12) for "feasibility of intervention implementation." We found high correlation between 3 prioritization criteria: "uncertainty or controversy about best practice," "unsatisfactory existing guidance," and "potential for changing existing guidance."
Conclusions: Our approach was feasible and efficient and may be useful for guideline projects where 2 or more guidance documents overlap and need to be updated.
Public and/or Consumer Involvement: At the time of this work, the patient representative in the guideline development group was unavailable and did not participate in the exercise.