The UpPriority Tool: Development of a prioritisation tool for updating clinical guideline questions

Article type
Authors
Martínez García L1, Pardo-Hernandez H1, Niño de Guzman E1, Superchi C1, Ballesteros M1, McFarlane E2, Posso M1, Roqué i Figuls M1, Sanabria AJ1, Selva A1, Sparrow K2, Vernooij RW1, Alonso-Coello P1
1Iberoamerican Cochrane Centre
2National Institute for Health and Care Excellence (NICE), UK
Abstract
Background: Due to the continuous emergence of new evidence, clinical guidelines (CGs) require regular surveillance of evidence to maintain their trustworthiness. Updating CGs is resource-intensive and time-consuming; therefore, updating may include a prioritisation process in order to efficiently ensure CGs remain up to date.

Objectives: To develop a pragmatic tool to prioritise clinical questions for updating within a CG. The specific objectives include: 1) to identify and describe the most important items required to prioritise clinical questions for updating; 2) to establish a rating scale of items and provide guidance on how to rate them; and, 3) to establish criteria on how to calculate and present priority scores in order to support decision making for updating clinical questions within a CG.

Methods: The development of the UpPriority Tool will consist of a multi-step process including: 1) generation of an initial version of the tool; 2) optimisation of the tool (feasibility test of the tool, semi-structured interviews, Delphi consensus survey, external review by CG methodologists and users, and pilot test of the tool); and, 3) approval of the final version of the tool.

Results: The initial version of the UpPriority Tool included six items: 1) availability of new relevant evidence; 2) relevance of clinical question; 3) replicability of clinical question; 4) users’ interest; 5) impact on access to healthcare (resource use and costs); and, 6) impact of outdated recommendations (safety). These items are assessed using a 7-point Likert scale. We also developed a score calculation and a summary report.

We will present the results of the feasibility test, the semi-structured interviews, and the Delphi consensus survey at the GES.

Conclusions: The UpPriority Tool will be developed for assessing any clinical question within a CG and should be easy to use in CG institutions.

The standardisation of prioritisation processes for CG updating using the UpPriority Tool will improve efficiency in CGs updating.