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Updating evidence-based clinical guidelines.

Martin Eccles1, Nikki Rousseau, Nick Freemantle

  • 1Centre for Health Services Research, University of Newcastle upon Tyne, UK.

Journal of Health Services Research & Policy
|April 6, 2002
PubMed
Summary
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Updating evidence-based guidelines involves multi-disciplinary teams and systematic reviews. While refining guidelines is faster than de novo development, cost savings are modest, highlighting a need for shared experiences and clearer updating methods.

Area of Science:

  • Health Services Research
  • Evidence-Based Practice

Background:

  • Evidence-based guidelines require regular updating to incorporate new research.
  • The North of England Evidence Based Guideline Development Programme has experience in guideline development.

Purpose of the Study:

  • To report on the process and outcomes of updating two existing evidence-based guidelines.
  • To compare the updating process with initial guideline development.

Main Methods:

  • Multi-disciplinary updating groups were convened, differing in composition from original development groups.
  • Systematic reviews were employed for evidence identification.
  • Guideline scope definition was expedited due to existing guideline versions.

Main Results:

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  • Updating allowed for refinement of group skills and size.
  • New and supplementary evidence led to updated and refined recommendations.
  • Modest overall savings were observed, with staff costs being the primary expense in both development and updating.

Conclusions:

  • Experience in updating evidence-based guidelines is limited, necessitating further sharing.
  • There is a need for explicit methods to guide decisions on when and how to update guidelines.