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2. Determine how to select topics for guideline develop-ment.
3. Describe processes for developing and revising guide-lines based on current evidence and for gaining consen-sus by developers.
4. Describe key challenges facing the guideline developer.METHODS: In this session, we will describe the methods theInstitute for Clinical Systems Improvement utilizes to developand revise guidelines. We will discuss how we garner peerreview of the documents prior to revision, the review of evi-dence, the group process utilized to review the document andthe peer review completed prior to publication. During thissession we will also present methods to reduce bias and obtainconsensus. We will review the process used to develop aimsand measures for improvement that organizations use in theirquality improvement activities. In addition we will discusssome of the current and future challenges of developing anddisseminating guidelines to practicing providers.RESULTS: None provided.DISCUSSION (CONCLUSION): None provided.TARGET AUDIENCE(S):
1. Guideline developer2. Guideline implementer3. Developer of guideline-based products4. Quality improvement manager/facilitator5. Health insurance payers and purchasers6. Medical providers and executives7. Allied health professionals8. Nurses
S29– Attitudes of guideline development groups
to use of GRADE in evidence evaluation and
development of recommendations
Judith Thornton, PhD (Presenter) (National InstituteHealth and Clinical Excellence, Manchester,England, United Kingdom); Tarang Sharma(National Institute Health and Clinical Excellence,Manchester, England, United Kingdom);Victoria Kelly (National Institute Health and ClinicalExcellence, Manchester, England, United Kingdom);Toni Tan (National Institute Health and ClinicalExcellence, Manchester, England, United Kingdom);Jonathan Nyong (National Institute Health andClinical Excellence, Manchester, England, UnitedKingdom); Faisal Siddiqui (National Institute Healthand Clinical Excellence, Manchester, England,United Kingdom); Lynda Ayiku (National InstituteHealth and Clinical Excellence, Manchester,England, United Kingdom)
PRIMARY TRACK: Guideline developmentSECONDARY TRACK: Guideline development groups/panels/committeesBACKGROUND (INTRODUCTION): The GRADE sys-tem is becoming widely used for assessing the quality ofevidence in guidelines. Although we have anecdotal reports
from members of guideline development groups (GDGs) in-volved in NICE guidelines, we have not formally assessedtheir opinions and whether they find the GRADE approachbeneficial. A literature search found no relevant informationfrom other guideline developers. Purpose: to examine whetherGDG members find GRADE useful when reviewing evidenceand formulating recommendations.LEARNING OBJECTIVES (TRAINING GOALS):
1. Determine opinions of members of guideline develop-ment groups to the GRADE approach.
2. Identify the best method of presenting GRADE method-ology to guideline development groups.
METHODS: A short questionnaire was sent to all GDGmembers before the start of evidence assessment with GRADEasking about general knowledge/use of evidence assessmentand GRADE, any preconceptions about GRADE, and whetherthey thought GRADE would help or hinder evidence assess-ment. A follow-up questionnaire was administered after com-pletion of the evidence review with questions about whetherGRADE helped or hindered evidence assessment, the specificbenefits and problems of GRADE, and how GRADE method-ology is best communicated to the GDG members.RESULTS: Four short clinical guidelines were identified forthe pilot study. All 9 GDG members of the first guideline weresent the pre-review questionnaire: All replied (2 patient/care-takers, 8 health-care professionals), response rate 100%. Twomembers had used GRADE previously when developing aNICE guideline and considered it helpful for consistency buthad concerns where few formal studies are available for well-established treatments. Three physicians were aware ofGRADE through the medical literature or implementation ofexisting guidelines.DISCUSSION (CONCLUSION): Follow-up question-naires will be sent at the end of evidence review. The projectwill then be expanded across the full clinical guideline pro-gram. From the results, we hope to determine how we canfurther support the GDGs when introducing GRADE method-ology.TARGET AUDIENCE(S):
1. Guideline developer
S30– Adapting the ADAPTE Framework
Christa Harstall, MHSA (Presenter) (Institute ofHealth Economics, Edmonton, Alberta, Canada);Paul Taenzer, PhD (Calgary Pain Program, Calgary,Alberta, Canada); Carmen Moga, MD (Institute ofHealth Economics, Edmonton, Alberta, Canada);Donna Angus, MHSA (Alberta Innovates - HealthSolutions, Edmonton, Alberta, Canada);Ann Scott, PhD (Edmonton, Alberta, Canada)
PRIMARY TRACK: Guideline developmentSECONDARY TRACK: Guideline development methodsBACKGROUND (INTRODUCTION): The ADAPTEschema outlines a systematic approach for adapting and con-textualizing guidelines. The Alberta Ambassador Program in-
25Oral Presentation