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Health Res Policy Syst. 2010 Mar 06;8:7. doi: 10.1186/1478-4505-8-7.

Prioritization strategies in clinical practice guidelines development: a pilot study.

Health research policy and systems

Ludovic Reveiz, Diana R Tellez, Juan S Castillo, Paola A Mosquera, Marcela Torres, Luis G Cuervo, Andres F Cardona, Rodrigo Pardo

Affiliations

  1. Clinical Research Institute and Health Technology Assessment Unit, National University, Bogota, Colombia. [email protected]

PMID: 20205926 PMCID: PMC2846928 DOI: 10.1186/1478-4505-8-7

Abstract

OBJECTIVE: Few methodological studies address the prioritization of clinical topics for the development of Clinical Practice Guidelines (CPGs). The aim of this study was to validate a methodology for Priority Determination of Topics (PDT) of CPGs.

METHODS AND RESULTS: Firstly, we developed an instrument for PDT with 41 criteria that were grouped under 10 domains, based on a comprehensive systematic search. Secondly, we performed a survey of stakeholders involved in CPGs development, and end users of guidelines, using the instrument. Thirdly, a pilot testing of the PDT procedure was performed in order to choose 10 guideline topics among 34 proposed projects; using a multi-criteria analysis approach, we validated a mechanism that followed five stages: determination of the composition of groups, item/domain scoring, weights determination, quality of the information used to support judgments, and finally, topic selection. Participants first scored the importance of each domain, after which four different weighting procedures were calculated (including the survey results). The process of weighting was determined by correlating the data between them. We also reported the quality of evidence used for PDT. Finally, we provided a qualitative analysis of the process. The main domains used to support judgement, having higher quality scores and weightings, were feasibility, disease burden, implementation and information needs. Other important domains such as user preferences, adverse events, potential for health promotion, social effects, and economic impact had lower relevance for clinicians. Criteria for prioritization were mainly judged through professional experience, while good quality information was only used in 15% of cases.

CONCLUSION: The main advantages of the proposed methodology are supported by the use of a systematic approach to identify, score and weight guideline topics selection, limiting or exposing the influence of personal biases. However, the methodology was complex and included a number of quantitative and qualitative approaches reflecting the difficulties of the prioritization process.

References

  1. CMAJ. 1994 Apr 15;150(8):1249-54 - PubMed
  2. CMAJ. 1995 Oct 1;153(7):901-7 - PubMed
  3. Lancet. 1988 Apr 2;1(8588):750-3 - PubMed
  4. Med Care. 2001 May;39(5):513-20 - PubMed
  5. Health Policy. 1997 Oct;42(1):67-81 - PubMed
  6. Health Technol Assess. 2004 Jul;8(31):1-103, iii - PubMed
  7. J Eval Clin Pract. 2007 Aug;13(4):627-31 - PubMed
  8. Health Policy. 2002 Dec;62(3):227-42 - PubMed
  9. J Med Internet Res. 2004 Oct 29;6(4):e39 - PubMed
  10. Health Res Policy Syst. 2006 Nov 29;4:14 - PubMed
  11. Health Res Policy Syst. 2006 Nov 29;4:15 - PubMed
  12. Lancet. 2004 Jul 31-Aug 6;364(9432):429-37 - PubMed
  13. J Adv Nurs. 2002 Oct;40(2):242-8 - PubMed
  14. J Adv Nurs. 2004 Nov;48(4):388-96 - PubMed
  15. CMAJ. 1995 Nov 1;153(9):1233-7 - PubMed

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