Methodological approaches and innovations applied during the guideline development
| Innovation . | Impact . |
|---|---|
| Centralized guideline project coordination with methods advisory group | Allowed discussion among guideline cochairs for decisions about process and methodology and communication about progress; ensured consistent methods were applied across the 10 guidelines; addressed challenges arising during the project with methodology experts |
| Explicit COI policy with management of financial and nonfinancial COIs | Ensured management of relevant COIs, while allowing participation in discussion of evidence through recusal per guideline question |
| Use of templates, guidance documents, and central panel training Web page | Streamlined training and consistent application of methods for SRWG members and panel members; reduced duplication of work among guideline groups |
| Health-outcome descriptors for outcome prioritization and utility rating (https://ms.gradepro.org/) | Facilitated prioritization of health outcomes and utility rating by panel members, including for outcomes not within their usual area of expertise |
| Updating and conducting new systematic reviews, application of indirect evidence, and expert evidence | Ensured all recommendations were evidence-based, including in areas with scarcity of RCTs and controlled observational studies; panels used indirect evidence when required; in areas lacking indirect evidence, systematic collection of panel experts’ observations and experiences through expert-based evidence forms allowed for formulation of recommendations on the basis of expert evidence |
| Research in context of guideline development (eg, living reviews, modeling in guidelines, formulating recommendations with use of expert evidence) | Planning for research projects in parallel with the development of the guidelines allowed for application and evaluation of new methods and approaches in real guidelines with a broad range of panels |
| Integration and updating of technology for guideline development and reporting (eg, GRADEpro app, online database of recommendations, and EtDs: https://gradepro.org/guidelines/) | Use of the GRADEpro application streamlined guideline production and reporting by having content of the evidence syntheses, panel decision-making, and recommendations centralized in an online format; it also allowed for electronic communication and online voting with panels; this also facilitated adaptation of recommendations for other settings, eg South America, using the GRADE Adolopment approach32 |
| Implementation tools and use of multiple formats for dissemination (eg, mobile app, patient versions, online interactive Summary of Findings tables, teaching slides) | Guideline recommendations and content from EtD frameworks were converted into the multiple formats to facilitate dissemination, user-friendliness, and implementation |
| Innovation . | Impact . |
|---|---|
| Centralized guideline project coordination with methods advisory group | Allowed discussion among guideline cochairs for decisions about process and methodology and communication about progress; ensured consistent methods were applied across the 10 guidelines; addressed challenges arising during the project with methodology experts |
| Explicit COI policy with management of financial and nonfinancial COIs | Ensured management of relevant COIs, while allowing participation in discussion of evidence through recusal per guideline question |
| Use of templates, guidance documents, and central panel training Web page | Streamlined training and consistent application of methods for SRWG members and panel members; reduced duplication of work among guideline groups |
| Health-outcome descriptors for outcome prioritization and utility rating (https://ms.gradepro.org/) | Facilitated prioritization of health outcomes and utility rating by panel members, including for outcomes not within their usual area of expertise |
| Updating and conducting new systematic reviews, application of indirect evidence, and expert evidence | Ensured all recommendations were evidence-based, including in areas with scarcity of RCTs and controlled observational studies; panels used indirect evidence when required; in areas lacking indirect evidence, systematic collection of panel experts’ observations and experiences through expert-based evidence forms allowed for formulation of recommendations on the basis of expert evidence |
| Research in context of guideline development (eg, living reviews, modeling in guidelines, formulating recommendations with use of expert evidence) | Planning for research projects in parallel with the development of the guidelines allowed for application and evaluation of new methods and approaches in real guidelines with a broad range of panels |
| Integration and updating of technology for guideline development and reporting (eg, GRADEpro app, online database of recommendations, and EtDs: https://gradepro.org/guidelines/) | Use of the GRADEpro application streamlined guideline production and reporting by having content of the evidence syntheses, panel decision-making, and recommendations centralized in an online format; it also allowed for electronic communication and online voting with panels; this also facilitated adaptation of recommendations for other settings, eg South America, using the GRADE Adolopment approach32 |
| Implementation tools and use of multiple formats for dissemination (eg, mobile app, patient versions, online interactive Summary of Findings tables, teaching slides) | Guideline recommendations and content from EtD frameworks were converted into the multiple formats to facilitate dissemination, user-friendliness, and implementation |