A demonstration of using formal consensus methods within guideline development; a case study

Area of Science:

• Medical Guidelines
• Clinical Practice
• Evidence-Based Medicine

Background:

• Guideline recommendations often rely on informal consensus when evidence is limited.
• Informal consensus may introduce biases inherent in group decision-making.
• Formal consensus methods offer a structured alternative to mitigate these biases.

Purpose of the Study:

• To apply formal consensus methods in developing recommendations for Neonatal Parenteral Nutrition guidelines.
• To evaluate the transparency and effectiveness of formal consensus in guideline creation.

Main Methods:

• A case study approach was used within the National Institute for Health and Care Excellence (NICE) guideline development.
• Ten high-quality published guidelines on neonatal parenteral nutrition were identified.
• Statements were generated and rated by a committee through two rounds of voting to reach agreement.

Main Results:

• The formal consensus process was systematic and enhanced transparency in recommendation development.
• Lessons learned include the importance of topic selection, adequate time allocation, and committee understanding of methodologies.
• The agreed-upon statements were successfully translated into guideline recommendations.

Conclusions:

• Formal consensus is a valuable tool for guideline development under specific conditions.
• This methodology ensures a clear and transparent process for creating clinical recommendations.
• The systematic nature of formal consensus aids in producing reliable and well-supported guidelines.