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      Development of rapid guidelines: 1. Systematic survey of current practices and methods

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          Abstract

          Background

          Guidelines in the healthcare field generally should contain evidence-based recommendations to inform healthcare decisions. Guidelines often require 2 years or more to develop, but certain circumstances necessitate the development of rapid guidelines (RGs) in a short period of time. Upholding methodological rigor while meeting the reduced development timeframe presents a challenge for developing RGs. Our objective was to review current practices and standards for the development of RGs. This is the first of a series of three articles addressing methodological issues around RGs.

          Methods

          We conducted a systematic survey of methods manuals and published RGs to identify reasons for the development of RGs. Data sources included existing guideline manuals, published RGs, Trip Medical Database, MEDLINE, EMBASE and communication with guideline developers until February 2018.

          Results

          We identified 46 guidelines that used a shortened timeframe for their development. Nomenclature describing RGs varied across organisations, wherein the United States Centers for Disease Control and Prevention produced ‘Interim Guidelines’, the National Institute for Health and Care Excellence in the United Kingdom developed ‘Short Clinical Guidelines’, and WHO provided ‘Rapid Advice’. The rationale for RGs included response to emergencies, rapid increases in cases of a condition or disease severity, or new evidence regarding treatment. In general, the methods to assess the quality of evidence, the consensus process and the management of the conflict of interest were not always clear. While we identified another 11 RGs from other institutions, there was no reference to timeframe and reasons for conducting a RG. The three organisations mentioned above provide guidance for the development of RGs.

          Conclusions

          There is a lack of standardised nomenclature and definitions regarding RGs and there is inconsistency in the methods described in manuals and in RG. It is therefore important that all RGs provide a detailed and transparent description of their methods in order for readers and end-users to be able to assess their quality and validate their findings.

          Electronic supplementary material

          The online version of this article (10.1186/s12961-018-0327-8) contains supplementary material, which is available to authorized users.

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          Most cited references 27

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          AGREE II: advancing guideline development, reporting and evaluation in health care.

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            Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise.

            Although several tools to evaluate the credibility of health care guidelines exist, guidance on practical steps for developing guidelines is lacking. We systematically compiled a comprehensive checklist of items linked to relevant resources and tools that guideline developers could consider, without the expectation that every guideline would address each item. We searched data sources, including manuals of international guideline developers, literature on guidelines for guidelines (with a focus on methodology reports from international and national agencies, and professional societies) and recent articles providing systematic guidance. We reviewed these sources in duplicate, extracted items for the checklist using a sensitive approach and developed overarching topics relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions and suggestions for items to be added. We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers. The topics and included items cover all stages of the guideline enterprise, from the planning and formulation of guidelines, to their implementation and evaluation. The final checklist includes links to training materials as well as resources with suggested methodology for applying the items. The checklist will serve as a resource for guideline developers. Consideration of items on the checklist will support the development, implementation and evaluation of guidelines. We will use crowdsourcing to revise the checklist and keep it up to date.
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              Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.

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                Author and article information

                Contributors
                sckowalskii@gmail.com , sergio.kowalski@ufpr.br
                morganrl@mcmaster.ca
                mfalavigna@yahoo.com.br
                ivan.florez@udea.edu.co , florezid@mcmaster.ca
                itzi.etxe@gmail.com
                wierciww@mcmaster.ca
                zhang243@mcmaster.ca
                faria.sakhia@medportal.ca
                liudmila.ivanova@medportal.ca
                santesna@mcmaster.ca
                +1 905 525 9140 , schuneh@mcmaster.ca
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                13 July 2018
                13 July 2018
                2018
                : 16
                Affiliations
                [1 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Department of Health Research Methods, Evidence and Impact and Mac GRADE Center, , McMaster University Health Sciences Centre, ; Room 2C16, 1280 Main Street West, Hamilton, ON L8N 4K1 Canada
                [2 ]ISNI 0000 0001 1941 472X, GRID grid.20736.30, Department of Internal Medicine, , Division of Rheumatology- Universidade Federal do Paraná, ; R. Gen. Carneiro, 181, Curitiba, PR Brazil
                [3 ]ISNI 0000 0004 0398 2134, GRID grid.414856.a, Hospital Moinhos de Vento, ; Porto Alegre, Brazil
                [4 ]ISNI 0000 0001 2200 7498, GRID grid.8532.c, National Institute of Science and Technology for Health Technology Assessment, , Federal University of Rio Grande do Sul, ; Porto Alegre, Brazil
                [5 ]ISNI 0000 0000 8882 5269, GRID grid.412881.6, Department of Pediatrics, , University of Antioquia, ; Cra. 51D #62-29, Medellin, 050001 Colombia
                [6 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Public Health & Preventive Medicine Residency Program (including Family Medicine), , McMaster University, ; 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
                [7 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Cochrane Canada Center, , McMaster University, Health Sciences Centre, Room 2C14, ; 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
                [8 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Department of Medicine, , McMaster University, Health Sciences Centre, Room 2C14, ; 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
                Article
                327
                10.1186/s12961-018-0327-8
                6044042
                30005712
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                Research
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                © The Author(s) 2018

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