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Clinical Practice Guidelines: Incorporating Input From a Patient Panel.

Susan M Goodman¹, Amy S Miller², Marat Turgunbaev²

¹Hospital for Special Surgery/Weill Cornell Medicine, New York, New York.

Arthritis Care & Research

|June 17, 2017

Summary

Patient input was crucial for the 2017 clinical practice guideline on managing rheumatic medications during hip and knee replacement surgery. Patients prioritized avoiding infection over disease flares, influencing the final recommendations.

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Involving Individuals with Developmental Language Disorder and Their Parents/Carers in Research Priority Setting

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Published on: June 6, 2020

Area of Science:

Rheumatology
Orthopedic Surgery
Clinical Practice Guidelines

Background:

Developing clinical practice guidelines requires integrating evidence with patient values.
Perioperative management of antirheumatic medication is critical for patients undergoing arthroplasty.
The 2017 American College of Rheumatology (ACR)/American Association of Hip and Knee Surgeons (AAHKS) guideline addressed this complex issue.

Purpose of the Study:

To elucidate the integral role of a Patient Panel in developing the 2017 ACR/AAHKS clinical practice guideline.
To understand how patient preferences influenced recommendations for perioperative medication management.
To assess the concordance between patient and expert panel decisions.

Main Methods:

A Patient Panel of 11 individuals with rheumatoid arthritis or juvenile idiopathic arthritis, who had undergone arthroplasty, was convened.
The panel reviewed evidence and voted on recommendations using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.
Patient values regarding infection risk versus disease flare were considered alongside expert panel discussions.

Main Results:

The Patient Panel prioritized avoiding perioperative infection over managing rheumatic disease flares.
The Voting Panel's decisions were concordant with the Patient Panel's input.
Agreement was reached on both the direction and conditional strength of 7 recommendations.

Conclusions:

Patient values and preferences significantly informed the 2017 ACR/AAHKS guideline.
The guideline development process successfully incorporated patient perspectives on risk-benefit trade-offs.
This approach highlights the importance of patient-centered care in guideline creation.