scholarly journals Processes for updating guidelines: protocol for a systematic review

2021 ◽  
Vol 4 ◽  
pp. 116
Author(s):  
Karen Cardwell ◽  
Joan Quigley ◽  
Barbara Clyne ◽  
Barrie Tyner ◽  
Marie Carrigan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Guidelines ◽  
Iterative Process ◽  
Clinical Guideline ◽  
Guideline Development ◽  
Grey Literature ◽  
Service Users ◽  
Narrative Synthesis ◽  
Literature Searching ◽  
Development Methodology

Background: National Clinical Guidelines are systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and service users’ decisions. Clinical guidelines require updating to ensure validly of the recommendations contained within. The purpose of this systematic review is to describe the most recent guideline update processes, including prioritisation methods, used by international or national groups who provide methods guidance for developing and updating clinical guidelines. Methods: A combination of searching a pre-defined list of international and national organisations that provide methods guidance for developing and updating clinical guidelines, together with grey literature searching, will be undertaken to identify relevant handbooks. This will be supplemented by a systematic literature search of Medline (EBSCO), Embase (OVID) and The Cochrane Methodology Register. As guideline development methodology has evolved considerably, the overall search span for this systematic review will be the last 10-years (2011-2021). Publications eligible for inclusion are methodological handbooks that provide updating guidance, including prioritisation methods, for clinical practice guidelines and peer-reviewed articles that describe or have implemented updating guidance, including prioritisation methods. Using Covidence, two reviewers will independently review titles/abstracts and full texts. Where disagreements occur, discussions will be held to reach consensus and where necessary, a third reviewer will be involved. Methodological handbooks will be quality assessed (using the GIN-McMaster Guideline Development Checklist) independently by two reviewers and any disagreements will be resolved by deliberation, or if necessary, a third reviewer. Data will be extracted by one reviewer and checked for inaccuracies/omissions by a second. A narrative synthesis will be undertaken. Conclusions: Updating clinical guidelines is an iterative process that is both resource intensive and time-consuming. The findings of this systematic review will support clinical guideline developers to ensure appropriate investment of resources.

scholarly journals Methodological quality of public health guideline recommendations on vitamin D and calcium : a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031840 ◽  
Author(s):  
Zhaoli Dai ◽  
Cynthia M Kroeger ◽  
Sally McDonald ◽  
Matthew J Page ◽  
Joanne E McKenzie ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Vitamin D ◽  
Bone Health ◽  
Methodological Quality ◽  
Guideline Development ◽  
Grey Literature ◽  
Dietary Guidelines ◽  
Published Data

IntroductionCurrent recommendations for vitamin D and calcium in dietary guidelines and bone health guidelines vary significantly among countries and professional organisations. It is unknown whether the methods used to develop these recommendations followed a rigourous process and how the differences in methods used may affect the recommended intakes of vitamin D and calcium. The objectives of this study are (1) collate and compare recommendations for vitamin D and calcium across guidelines, (2) appraise methodological quality of the guideline recommendations and (3) identify methodological factors that may affect the recommended intakes for vitamin D and calcium. This study will make a significant contribution to enhancing the methodological rigour in public health guidelines for vitamin D and calcium recommendations.Methods and analysesWe will conduct a systematic review to evaluate vitamin D and calcium recommendations for osteoporosis prevention in generally healthy middle-aged and older adults. Methodological assessment will be performed for each guideline against those outlined in the 2014 WHO handbook for guideline development. A systematic search strategy will be applied to locate food-based dietary guidelines and bone health guidelines indexed in various electronic databases, guideline repositories and grey literature from 1 January 2009 to 28 February 2019. Descriptive statistics will be used to summarise the data on intake recommendation and on proportion of guidelines consistent with the WHO criteria. Logistic regression, if feasible, will be used to assess the relationships between the methodological factors and the recommendation intakes.Ethics and disseminationEthics approval is not required as we will only extract published data or information from the published guidelines. Results of this review will be disseminated through conference presentations and peer-reviewed publications.PROSPERO registration numberCRD42019126452

scholarly journals Do clinical guidelines for whole body computerised tomography in trauma improve diagnostic accuracy and reduce unnecessary investigations? A systematic review and narrative synthesis

Trauma ◽  
2017 ◽  
Vol 19 (3) ◽  
pp. 163-174 ◽  
Author(s):  
Nicholas P Hare ◽  
Alistair W Macdonald ◽  
James P Mellor ◽  
Maaz Younus ◽  
Hridesh Chatha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Clinical Guidelines ◽  
De Novo ◽  
Whole Body ◽  
Routine Practice ◽  
Significant Finding ◽  
Narrative Synthesis ◽  
Computerised Tomography ◽  
Manual Search

Introduction Whole body computerised tomography has become a standard of care for the investigation of major trauma patients. However, its use varies widely, and current clinical guidelines are not universally accepted. We undertook a systematic review of the literature to determine whether clinical guidelines for whole body computerised tomography in trauma increase its diagnostic accuracy. Materials and methods A systematic review of Medline, Cinhal and the Cochrane database, supplemented by a manual search of relevant papers was undertaken, with narrative synthesis. Studies comparing clinical guidelines to physician gestalt for the use of whole body computerised tomography in adult trauma were included. Results A total of 887 papers were identified from the electronic databases, and 1 from manual searches. Of these, seven papers fulfilled the inclusion criteria. Two papers compared clinical guidelines with routine practice: one found increased diagnostic accuracy while the other did not. Two papers investigated the performance of established clinical guidelines and demonstrated moderate sensitivity and low specificity. Two papers compared different components of established triage tools in trauma. One paper devised a de novo clinical decision rule, and demonstrated good diagnostic accuracy with the tool. The outcome criteria used to define a ‘positive’ scan varied widely, making direct comparisons between studies impossible. Conclusions Current clinical guidelines for whole body computerised tomography in trauma may increase the sensitivity of the investigation, but the evidence to support this is limited. There is a need to standardise the definition of a ‘clinically significant’ finding on CT to allow better comparison of diagnostic studies.

scholarly journals Systematic review automation tool use by systematic reviewers, health technology assessors and clinical guideline developers: tools used, abandoned, and desired

2021 ◽  
Author(s):  
Anna Mae Scott ◽  
Connor Forbes ◽  
Justin Clark ◽  
Matt Carter ◽  
Paul Glasziou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Guideline ◽  
Guideline Development ◽  
Data Extraction ◽  
Evidence Synthesis ◽  
Health Technology ◽  
Tool Development ◽  
Time Savings ◽  
Automation Tools ◽  
Question Survey

Objective We investigated the use of systematic review automation tools by systematic reviewers, health technology assessors and clinical guideline developers. Study design and settings An online, 16-question survey was distributed across several evidence synthesis, health technology assessment and guideline development organisations internationally. We asked the respondents what tools they use and abandon, how often and when they use the tools, their perceived time savings and accuracy, and desired new tools. Descriptive statistics were used to report the results. Results 253 respondents completed the survey; 89% have used systematic review automation tools - most frequently whilst screening (79%). Respondents' Top 3 tools include: Covidence (45%), RevMan (35%), Rayyan and GRADEPro (both 22%); most commonly abandoned were Rayyan (19%), Covidence (15%), DistillerSR (14%) and RevMan (13%). Majority thought tools saved time (80%) and increased accuracy (54%). Respondents taught themselves to how to use the tools (72%), and were most often prevented by lack of knowledge from their adoption (51%). Most new tool development was suggested for the searching and data extraction stages. Conclusion Automation tools are likely to take on an increasingly important role in high quality and timely reviews. Further work is required in training and dissemination of automation tools and ensuring they meet the desirable features of those conducting systematic reviews.

scholarly journals Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e029478 ◽  
Author(s):  
Gina Marie Awoko Higginbottom ◽  
Catrin Evans ◽  
Myfanwy Morgan ◽  
Kuldip Kaur Bharj ◽  
Jeanette Eldridge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Professionals ◽  
Maternity Care ◽  
Immigrant Women ◽  
Grey Literature ◽  
Further Education ◽  
Social Needs ◽  
Narrative Synthesis ◽  
Foreign Born ◽  
The Uk

One in four births in the UK is to foreign-born women. In 2016, the figure was 28.2%, the highest figure on record, with maternal and perinatal mortality also disproportionately higher for some immigrant women. Our objective was to examine issues of access and experience of maternity care by immigrant women based on a systematic review and narrative synthesis of empirical research.Review methodsA research librarian designed the search strategies (retrieving literature published from 1990 to end June 2017). We retrieved 45 954 citations and used a screening tool to identify relevance. We searched for grey literature reported in databases/websites. We contacted stakeholders with expertise to identify additional research.ResultsWe identified 40 studies for inclusion: 22 qualitative, 8 quantitative and 10 mixed methods. Immigrant women, particularly asylum-seekers, often booked and accessed antenatal care later than the recommended first 10 weeks. Primary factors included limited English language proficiency, lack of awareness of availability of the services, lack of understanding of the purpose of antenatal appointments, immigration status and income barriers. Maternity care experiences were both positive and negative. Women with positive perceptions described healthcare professionals as caring, confidential and openly communicative in meeting their medical, emotional, psychological and social needs. Those with negative views perceived health professionals as rude, discriminatory and insensitive to their cultural and social needs. These women therefore avoided continuously utilising maternity care.We found few interventions focused on improving maternity care, and the effectiveness of existing interventions have not been scientifically evaluated.ConclusionsThe experiences of immigrant women in accessing and using maternity care services were both positive and negative. Further education and training of health professionals in meeting the challenges of a super-diverse population may enhance quality of care, and the perceptions and experiences of maternity care by immigrant women.

scholarly journals A systematic review of factors that enable psychological safety in healthcare teams

2020 ◽  
Vol 32 (4) ◽  
pp. 240-250 ◽  
Author(s):  
Róisín O’donovan ◽  
Eilish Mcauliffe
Keyword(s):  
Systematic Review ◽  
Keyword Search ◽  
Data Extraction ◽  
Grey Literature ◽  
Psychological Safety ◽  
Healthcare Setting ◽  
Narrative Synthesis ◽  
Observational Measures ◽  
Healthcare Teams ◽  
Study Selection

Abstract Purpose The current systematic review will identify enablers of psychological safety within the literature in order to produce a comprehensive list of factors that enable psychological safety specific to healthcare teams. Data sources A keyword search strategy was developed and used to search the following electronic databases PsycINFO, ABI/INFORM, Academic search complete and PubMed and grey literature databases OpenGrey, OCLC WorldCAT and Espace. Study selection Peer-reviewed studies relevant to enablers of psychological safety in healthcare setting that were published between 1999 and 2019 were eligible for inclusion. Covidence, an online specialized systematic review website, was used to screen records. Data extraction, quality appraisal and narrative synthesis were conducted on identified papers. Data extraction Thirty-six relevant studies were identified for full review and data extraction. A data extraction template was developed and included sections for the study methodology and the specific enablers identified within each study. Results of data synthesis Identified studies were reviewed using a narrative synthesis. Within the 36 articles reviewed, 13 enablers from across organizational, team and individual levels were identified. These enablers were grouped according to five broader themes: priority for patient safety, improvement or learning orientation, support, familiarity with colleagues, status, hierarchy and inclusiveness and individual differences. Conclusion This systematic review of psychological safety literature identifies a list of enablers of psychological safety within healthcare teams. This list can be used as a first step in developing observational measures and interventions to improve psychological safety in healthcare teams.

scholarly journals Healthcare provider characteristics that influence the implementation of individual-level patient-centered outcome measure (PROM) and patient-reported experience measure (PREM) data across practice settings: a protocol for a mixed methods systematic review with a narrative synthesis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Angela C. Wolff ◽  
Andrea Dresselhuis ◽  
Samar Hejazi ◽  
Duncan Dixon ◽  
Deborah Gibson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Point Of Care ◽  
Data Extraction ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Influential Factors ◽  
Narrative Synthesis ◽  
Individual Level ◽  
Patient Reported

Abstract Background Substantial literature has highlighted the importance of patient-reported outcome and experience measures (PROMs and PREMs, respectively) to collect clinically relevant information to better understand and address what matters to patients. The purpose of this systematic review is to synthesize the evidence about how healthcare providers implement individual-level PROMs and PREMs data into daily practice. Methods This mixed methods systematic review protocol describes the design of our synthesis of the peer-reviewed research evidence (i.e., qualitative, quantitative, and mixed methods), systematic reviews, organizational implementation projects, expert opinion, and grey literature. Keyword synonyms for “PROMs,” PREMs,” and “implementation” will be used to search eight databases (i.e., MEDLINE, CINAHL, PsycINFO, Web of Science, Embase, SPORTDiscus, Evidence-based Medicine Reviews, and ProQuest (Dissertation and Theses)) with limiters of English from 2009 onwards. Study selection criteria include implementation at the point-of-care by healthcare providers in any practice setting. Eligible studies will be critically appraised using validated tools (e.g., Joanna Briggs Institute). Guided by the review questions, data extraction and synthesis will occur simultaneously to identify biographical information and methodological characteristics as well as classify study findings related to implementation processes and strategies. As part of the narrative synthesis approach, two frameworks will be utilized: (a) Consolidated Framework for Implementation Research (CFIR) to identify influential factors of PROMs and PREMs implementation and (b) Expert Recommendations for Implementing Change (ERIC) to illicit strategies. Data management will be undertaken using NVivo 12TM. Discussion Data from PROMs and PREMs are critical to adopt a person-centered approach to healthcare. Findings from this review will guide subsequent phases of a larger project that includes interviews and a consensus-building forum with end users to create guidelines for implementing PROMs and PREMs at the point of care. Systematic review registration PROSPERO CRD42020182904.

scholarly journals Factors influencing nurses' engagement with CPD activities: a systematic review

2021 ◽  
Vol 30 (1) ◽  
pp. 60-68
Author(s):  
Juliette K Walter ◽  
Louise M Terry
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Continuing Professional Development ◽  
British Library ◽  
Narrative Synthesis ◽  
Managerial Support ◽  
Factors Influencing ◽  
Review Protocol ◽  
Review Question ◽  
The Uk

Background: Continuing professional development (CPD) is necessary for nurse registration and development. Understanding the factors influencing engagement may enhance CPD uptake. Review question: What factors influence hospital-based nurses' engagement with CPD activities in the UK? Design: This was a systematic review incorporating narrative synthesis. Database searches for published and grey literature from January 1995 to November 2018 were conducted via EBSCO Discovery Service, the British Nursing Index and the British Library. Review methods: An approved systematic review protocol was followed with studies then assessed against strict inclusion and exclusion criteria. Included studies were critically appraised, data extracted and a narrative synthesis conducted. Findings: Five studies were reviewed. Four themes emerged: nurses' individual resources, their professional motivation, organisational commitment to learning and development, and managerial support. Conclusion: Factors influencing nurses' engagement with activities are multifaceted and inter-woven. A question-based checklist to facilitate discussions between nurses and educators, managers or appraisers is presented.

Clinical Guideline Development for Otitis Media: A Report on Methodology

1993 ◽  
Vol 109 (3) ◽  
pp. 478-481 ◽  
Author(s):  
Anthony E. Magit ◽  
Sylvan E. Stool
Keyword(s):  
Otitis Media ◽  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Otitis Media With Effusion ◽  
Guideline Development ◽  
Clinical Settings ◽  
Multiple Factors ◽  
Contemporary Practice ◽  
Major Emphasis ◽  
Head Neck

Clinical guideline development is a major emphasis of recent health policy efforts. Interest in clinical guidelines is the result of multiple factors, including economic pressures and the desire to achieve a baseline level of practice in clinical settings. Guidelines have always been of fundamental importance in medicine. This article will discuss the place clinical guidelines have in contemporary practice and the difficulties encountered in the process of developing a meaningful guideline for managing otitis media with effusion. (OTOLARYNGOL HEAD NECK SURG 1993;109:478-81.)

scholarly journals Economic evaluation of clinical quality registries: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030984 ◽  
Author(s):  
Peter Lee ◽  
Ken Chin ◽  
Danny Liew ◽  
Dion Stub ◽  
Angela L Brennan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Grey Literature ◽  
Bibliographic Databases ◽  
Narrative Synthesis ◽  
Clinical Quality ◽  
Government Report ◽  
The Government ◽  
The Cost

ObjectivesThe objective of this systematic review was to examine the existing evidence base for the cost-effectiveness or cost-benefit of clinical quality registries (CQRs).DesignSystematic review and narrative synthesis.Data sourcesNine electronic bibliographic databases, including MEDLINE, EMBASE and CENTRAL, in the period from January 2000 to August 2019.Eligibility criteriaAny peer-reviewed published study or grey literature in English which had reported on an economic evaluation of one or more CQRs.Data extraction and synthesisData were screened, extracted and appraised by two independent reviewers. A narrative synthesis was performed around key attributes of each CQR and on key patient outcomes or changes to healthcare processes or utilisation. A narrative synthesis of the cost-effectiveness associated with CQRs was also conducted. The primary outcome was cost-effectiveness, in terms of the estimated incremental cost-effectiveness ratio (ICER), cost savings or return-on-investment (ROI) attributed to CQR implementation.ResultsThree studies and one government report met the inclusion criteria for the review. A study of the National Surgical Quality Improvement Programme (NSQIP) in the USA found that the cost-effectiveness of this registry improved over time, based on an ICER of US$8312 per postoperative event avoided. A separate study in Canada estimated the ROI to be US$3.43 per US$1.00 invested in the NSQIP. An evaluation of a post-splenectomy CQR in Australia estimated that registry cost-effectiveness improved from US$234 329 to US$18 358 per life year gained when considering the benefits accrued over the lifetime of the population. The government report evaluating five Australian CQRs estimated an overall return of 1.6–5.5 times the cost of investment.ConclusionsAvailable data indicate that CQRs can be cost-effective and can lead to significant returns on investment. It is clear that further studies that evaluate the economic and clinical impacts of CQRs are necessary.PROSPERO registration numberCRD42018116807.

scholarly journals Prioritization approaches in the development of health practice guidelines: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Amena El-Harakeh ◽  
Rami Z. Morsi ◽  
Racha Fadlallah ◽  
Lama Bou-Karroum ◽  
Tamara Lotfi ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
Iterative Process ◽  
Development Process ◽  
Guideline Development ◽  
Grey Literature ◽  
Included Study ◽  
Practice Variation ◽  
Health Practice ◽  
Sufficient Detail ◽  
Common Framework

Abstract Background Given the considerable efforts and resources required to develop practice guidelines, developers need to prioritize what topics and questions to address. This study aims to identify and describe prioritization approaches in the development of clinical, public health, or health systems guidelines. Methods We searched Medline and CINAHL electronic databases in addition to Google Scholar. We included papers describing prioritization approaches in sufficient detail allowing for reproducibility. We synthesized findings in a semi-quantitative way. We followed an iterative process to develop a common framework of prioritization criteria that captures all of the criteria reported by each included study. Results Our search captured 33,339 unique citations out of which we identified 10 papers reporting prioritization approaches for guideline development. All of the identified approaches focused on prioritizing guideline topics but none on prioritizing recommendation questions or outcomes. The two most frequently reported steps of the development process for these approaches were reviewing the grey literature (9 out of 10, 90%) and engaging various stakeholders (9 out of 10, 90%). We derived a common framework of 20 prioritization criteria that can be used when prioritizing guideline topics. The most frequently reported criteria were the health burden of disease which was included in all of the approaches, practice variation (8 out of 10, 80%), and impact on health outcomes (7 out of 10, 70%). Two of the identified approaches stood out as being comprehensive and detailed. Conclusions We described 10 prioritization approaches in the development of health practice guidelines. There is a need to assess the effectiveness, efficiency and transparency of the identified approaches and to develop standardized and validated priority setting tools.

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