Guidelines experts present framework for developing living practice guidelines in health care

Abstract: https://www.acpjournals.org/doi/10.7326/M22-0514    

Editorial: https://www.acpjournals.org/doi/10.7326/M22-1813    

URLs go live when the embargo lifts

Guidelines experts reviewed existing research and conducted their own to present a framework for developing living practice guidelines in health care. The framework provides specific instruction for the planning, production, reporting, and dissemination of such guidelines and highlights the considerations specific to each of those areas in the context of a living document. The advice is published in Annals of Internal Medicine.

Rigorously developed, disseminated, and implemented practice guidelines promote health, prevent harm, encourage best practice, and reduce practice variation. Since the COVID-19 pandemic, living practice guidelines, or those that are updated as new evidence becomes available, are increasingly being used to ensure that recommendations are responsive to rapidly emerging evidence.

A team of 51 multidisciplinary researchers from the Living Guidelines Group studied methods papers and conducted a review of handbooks of guideline producing organizations and an analytic review of selected living practice guidelines to develop a framework that characterizes the processes of development of living practice guidelines in health care.  The framework builds on the Guidelines International Network–McMaster guideline development checklist to address aspects specific or particularly relevant to the living guideline process. The researchers provide definitions of key concepts used in developing living practice guidelines and detail 4 specific areas — planning, producing, reporting, dissemination, and accessibility. They explain that the planning process should address the organization’s adoption of the living methodology as well as each specific guideline project. The production process consists of initiation, maintenance, and retirement phases. The reporting should cover the evidence surveillance time stamp, the outcome of reassessment of the body of evidence (when applicable), and the outcome of revisiting a recommendation (when applicable). The dissemination process may necessitate the use of different venues, including one for formal publication.

According to the authors, the framework should help guideline developers in both planning and conducting their living guideline projects.

Media contacts: For an embargoed PDF or contact information for an author, please contact Angela Collom at [email protected].