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Assessing the process and outcome of the development of practice guidelines and recommendations: PANELVIEW instrument
Wojtek Wiercioch1, Elie A Akl1, Nancy Santesso1
1Department of Health Research Methods, Evidence, and Impact (Wiercioch, Akl, Santesso, Zhang, Morgan, Baldeh, Mustafa, Etxeandia-Ikobaltzeta, Carrasco-Labra, Ventresca, Brignardello-Petersen, Morgano, Brożek, Schünemann), McMaster University, Hamilton, Ont.; Department of Internal Medicine (Akl), American University of Beirut, Beirut, Lebanon; School of Medicine (Yepes-Nuñez), Universidad de los Andes, Bogotá, Colombia; Department of Internal Medicine (Kowalski), Federal University of Paraná, Curitiba, Brazil; Division of Nephrology and Hypertension (Mustafa), Department of Medicine, University of Kansas Medical Center, Kansas City, Kan.; Guideline Development Group (Laisaar), Faculty of Medicine, Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Ministry of Social Affairs (Raid), Tallinn, Estonia; Department of Internal Medicine (Neumann), Pontificia Universidad Católica de Chile, Santiago, Chile; Federal University of Rio Grande do Sul (Falavigna), Institute for Health Technology Assessment, Porto Alegre, Brazil; Department of Medicine (Brożek, Schünemann), McMaster University, Hamilton, Ont.; Department of Innovation in Medical Education (McConnell), University of Ottawa, Ottawa, Ont.
Background:
Guideline recommendations may be affected by flaws in the process, inappropriate panel member selection or conduct, conflicts of interest and other factors. To our knowledge, no validated tool exists to evaluate guideline development from the perspective of those directly involved in the process. Our objective was to develop and validate a universal tool, the PANELVIEW instrument, to assess guideline processes, methods and outcomes from the perspective of the participating guideline panellists and group members.
Methods:
We performed a systematic literature search and surveys of guideline groups (identified through contacting international organizations and convenience sampling of working panels) to inform item generation. Subsequent groups of guideline methodologists and panellists reviewed items for face validity and missing items. We used surveys, interviews and expert review for item reduction and phrasing. For reliability assessment and feedback, we tested the PANELVIEW tool in 8 international guideline groups.
Results:
We surveyed 62 members from 13 guideline panels, contacted 19 organizations and reviewed 20 source documents to generate items. Fifty-three additional key informants provided feedback about phrasing of the items and response options. We reduced the number of items from 95 to 34 across domains that included administration, training, conflict of interest, group dynamics, chairing, evidence synthesis, formulating recommendations and publication. The tool takes about 10 minutes to complete and showed acceptable measurement properties.
Interpretation:
The PANELVIEW instrument fills a gap by enabling guideline organizations to involve clinicians, patients and other participants in evaluating their guideline processes. The tool can inform quality improvement of existing or new guideline programs, focusing on insight into and transparency of the guideline development process, methods and outcomes.
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