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Methodological systematic review identifies major limitations in prioritization processes for updating.

Laura Martínez García1, Hector Pardo-Hernandez1, Cecilia Superchi1

  • 1Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Maria Claret 167, Pavelló 18 - planta 0, Barcelona 08025, Spain.

Journal of Clinical Epidemiology
|May 28, 2017
PubMed
Summary

This study identified strategies for updating systematic reviews (SRs), health technology assessments (HTAs), and clinical guidelines (CGs). Prioritization criteria like available evidence and clinical relevance are key, but reporting methods vary.

Keywords:
Clinical guidelinesMethodologyPrioritizationSystematic reviewTechnology assessmentUpdating

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Area of Science:

  • Health Sciences
  • Evidence-Based Medicine
  • Research Methodology

Background:

  • Systematic reviews (SRs), health technology assessments (HTAs), and clinical guidelines (CGs) require regular updating to remain current.
  • Prioritizing which of these documents to update is crucial for efficient resource allocation.
  • Existing methods for prioritization are not well-documented or consistently applied.

Purpose of the Study:

  • To identify and describe existing strategies for prioritizing the updating of SRs, HTAs, and CGs.
  • To analyze the methods and criteria used in prioritization processes.
  • To highlight variability in the reporting of these prioritization strategies.

Main Methods:

  • A systematic review of studies describing prioritization methods for updating SRs, HTAs, or CGs.
  • Searches conducted in MEDLINE and The Cochrane Methodology Register.
  • Data extraction and screening performed independently by two reviewers.

Main Results:

  • Fourteen studies were included, with 57.1% focusing on implementation and 42.9% on descriptive aspects.
  • Six studies reported updating strategies, six a prioritization process, and two a prioritization criterion.
  • Seventy-six prioritization criteria were identified, with 'available evidence' (25.0%), 'clinical relevance' (13.2%), and 'users' interest' (13.2%) being most frequent.
  • Eight studies focused on SRs and six on CGs; no studies focused solely on HTAs.

Conclusions:

  • There is significant variability in the methods used to develop and implement prioritization processes for updating SRs, HTAs, and CGs.
  • Reporting of these methods is often suboptimal, hindering consistent application and comparison.
  • Further standardization and transparent reporting of prioritization strategies are needed.