Assessing the need to update prevention guidelines: a comparison of two methods

Area of Science:

• Health Services Research
• Evidence-Based Medicine
• Clinical Practice Guidelines

Background:

• Determining when to update clinical practice guidelines is crucial for maintaining evidence-based recommendations.
• High costs associated with guideline updates necessitate efficient assessment methods.
• A proposed model by Shekelle et al. uses limited literature searches and expert input to reduce update assessment costs.

Purpose of the Study:

• To compare the comprehensiveness and effort of the Shekelle et al. assessment model (review approach) against traditional systematic review methods.
• To refine the review approach iteratively for enhanced efficiency.
• To evaluate the effectiveness of both methods in assessing the need for guideline updates.

Main Methods:

• The study employed a refined version of the Shekelle et al. review approach and a traditional systematic review process.
• Both methods were independently applied to assess updates for six topics from the 1996 Guide to Clinical Preventive Services.
• Key outcomes measured included the completeness of study identification, the importance of any missed studies, and the overall effort involved.

Main Results:

• The review approach identified fewer eligible studies but missed no studies deemed important by task force liaisons.
• The review approach resulted in significantly fewer citations requiring review compared to the traditional approach.
• Effort and time savings varied depending on the specific topic's scope.

Conclusions:

• The refined review approach offers an efficient and acceptable method for evaluating the necessity of clinical practice guideline updates.
• This approach can help streamline the guideline maintenance process, ensuring continued relevance and evidence base.