Updated recommendations : An assessment of NICE clinical guidelines
Martínez García, Laura (Institut d'Investigació Biomèdica Sant Pau)
McFarlane, Emma (National Institute for Health and Care Excellence (Regne Unit))
Barnes, Steven (National Institute for Health and Care Excellence (Regne Unit))
Sanabria, Andreu Juliana (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Alonso-Coello, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Alderson, Philip (National Institute for Health and Care Excellence (Regne Unit))
Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública

Fecha:	2014
Resumen:	Background: Updating is important to ensure clinical guideline (CG) recommendations remain valid. However, little research has been undertaken in this field. We assessed CGs produced by the National Institute for Health and Care Excellence (NICE) to identify and describe updated recommendations and to investigate potential factors associated with updating. Also, we evaluated the reporting and presentation of recommendation changes. Methods: We performed a descriptive analysis of original and updated CGs and recommendations, and an assessment of presentation formats and methods for recording information. We conducted a case-control study, defining cases as original recommendations that were updated ('new-replaced' recommendations), and controls as original recommendations that were considered to remain valid ('not changed' recommendations). We performed a comparison of main characteristics between cases and controls, and we planned a multiple regression analysis to identify potential predictive factors for updating. Results: We included nine updated CGs (1,306 recommendations) and their corresponding original versions (1,106 recommendations). Updated CGs included 812 (62%) recommendations 'not reviewed', 368 (28. 1%) 'new' recommendations, 104 (7. 9%) 'amended' recommendations, and 25 (1. 9%) recommendations reviewed but unchanged. The presentation formats used to indicate the changes in recommendations varied widely across CGs. Changes in 'amended', 'deleted', and 'new-replaced' recommendations (n = 296) were reported infrequently, mostly in appendices. These changes were recorded in 167 (56. 4%) recommendations; and were explained in 81 (27. 4%) recommendations. We retrieved a total of 7. 1% (n = 78) case recommendations ('new-replaced') and 2. 4% (n = 27) control recommendations ('not changed') in original CGs. The updates were mainly from 'Fertility CG', about 'gynaecology, pregnancy and birth' topic, and 'treatment' or 'prevention' purposes. We did not perform the multiple regression analysis as originally planned due to the small sample of recommendations retrieved. Conclusion: Our study is the first to describe and assess updated CGs and recommendations from a national guideline program. Our results highlight the pressing need to standardise the reporting and presentation of updated recommendations and the research gap about the optimal way to present updates to guideline users. Furthermore, there is a need to investigate updating predictive factors. © 2014 Martínez García et al. ; licensee BioMed Central Ltd.
Ayudas:	Ministerio de Ciencia e Innovación CM11/00035 Ministerio de Economía y Competitividad CM12/00168 Ministerio de Ciencia e Innovación CP09/00137
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Clinical practice guidelines ; Evidence-based medicine ; Information dissemination ; Knowledge translation ; Methods ; Updating
Publicado en:	Implementation Science, Vol. 9 Núm. 1 (november 2014) , p. 72, ISSN 1748-5908

DOI: 10.1186/1748-5908-9-72
PMID: 24919856

9 p, 436.2 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
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