Speed things up! How to accelerate the uptake of research results into clinical guidelines and practice

Article type
Authors
Heus P1, Hooft L1, Kusters M1, Leereveld D2, van Barneveld T2, Vernooij R1, Zwarts - van de Putte R2
1Cochrane Netherlands, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
2Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands
Abstract
Background:
In the Netherlands, it typically takes 10 to 14 years from knowledge question formulation to its translation into clinical guidelines, of which 5 to 7 years is for research results uptake. This prolonged timeframe is unacceptable, highlighting the need for acceleration. Regular revision of guideline modules based on current medical-scientific evidence is essential to maintain their relevance and validity for clinical practice.

Objectives:
To speed up the uptake of research results into clinical guidelines.

Methods:
Twenty-five high potential studies (ie, important topics, promising results) funded by The Netherlands Organization for Health Research and Development were taken as a starting point for potential guideline module development or updating. To expedite the process, we implemented a modified strategy, deviating from the regular guideline trajectory. Changes were instituted in several phases, including scope definition, problem analysis, guideline panel composition, stakeholder consultation, and guideline authorization. We conducted an overarching evaluation to learn from experiences and inform future medical guideline maintenance and research agenda-setting.

Results:
Fourteen studies (14/25, 56%) led to a new or revised guideline module, of which two resulted in newly developed modules (2/14) and six in revised modules including policy changes (6/14). Duration of results uptake varied between 12 and 26 months.
Delaying factors in the early process’ phases were expert delegation by scientific organizations, explaining the modified process to stakeholders, and discussions on PICO formulation and on whether results of a single study were sufficient for revision of a guideline module. Also, shortening stakeholder consultation appeared not be feasible. Interestingly, for none of the studies, the resulting guideline recommendations were incorporated in the Dutch national implementation agenda, mainly due to weak or unchanged recommendations not needing an implementation impulse according to the panel.

Conclusions:
Even though the timeframe was shortened, there is still plenty of potential for process improvement. Therefore, it is strongly encouraged to strengthen the collaboration between researchers, research funding organizations, evidence synthesizers, and medical guideline developers.

Relevance and Importance to Patients:
Clinical guidelines are essential for informed health decision-making. Both professionals and patients benefit from guidelines based on current evidence. Patient organizations were represented among the stakeholders involved in this project.