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Updating the Canadian clinical practice guideline for managing pediatric obesity: a protocol
Bradley C Johnston1, Roah Merdad1, Diana Sherifali1
1Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont.
Insights
This study outlines the protocol for updating Canada's pediatric obesity management guidelines, incorporating new evidence and standards for better clinical decisions.
Area of Science:
- Public Health
- Clinical Practice Guidelines
- Pediatric Endocrinology
Background:
- The 2007 Canadian clinical practice guideline for obesity management requires updating due to new evidence and evolving standards.
- This protocol focuses on revising the pediatric components of the existing guideline.
Purpose of the Study:
- To describe the protocol for updating the Canadian clinical practice guideline for managing pediatric obesity.
- To ensure informed, value-sensitive, and evidence-based clinical decisions for pediatric obesity management.
Main Methods:
- The guideline update follows National Academy of Medicine and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) standards.
- Five literature reviews (one scoping, four systematic) will synthesize evidence on assessment, values, preferences, and intervention safety/effectiveness.
- Standard systematic review methodology will be employed, including evidence certainty assessment and recommendation strength determination.
Main Results:
- This protocol aims to produce an updated, evidence-based clinical practice guideline for pediatric obesity management in Canada.
- The guideline will be developed with input from diverse stakeholders, including families and clinicians.
- Knowledge translation strategies will be used for optimal dissemination.
Conclusions:
- The updated guideline will support Canadian healthcare providers and families in making informed decisions regarding pediatric obesity.
- The guideline will be published in English and French, with resources for end-users.
- Partnership with Obesity Canada will enhance dissemination and knowledge translation efforts.
Background:
Since the first national guideline for managing obesity in adults and children in Canada was published in 2007, new evidence has emerged and guideline standards have evolved. Our purpose is to describe the protocol used to update the Canadian clinical practice guideline for managing pediatric obesity.
Methods:
This guideline will update the pediatric components of the 2007 Canadian clinical practice guideline for the management of obesity. In partnership with Obesity Canada, we began preliminary work in 2019; activities are scheduled for completion in 2022. The guideline will follow standards developed by the National Academy of Medicine and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) working group. Guideline development will be informed by 5 complementary literature reviews: a scoping review that focuses on clinical assessment in pediatric obesity management and 4 systematic reviews to synthesize evidence regarding families' values and preferences as well as the safety and effectiveness of interventions (psychological and behavioural; pharmacotherapeutic; and surgical). We will use standard systematic review methodology, including summarizing and assessing the certainty of evidence and determining the strength of recommendations. Competing interests will be managed proactively according to recommendations from the Guidelines International Network. Diverse stakeholders, including families and clinicians, will be engaged throughout guideline development.
Interpretation:
The guideline will support Canadian families and clinicians to make informed, value-sensitive and evidence-based clinical decisions related to managing pediatric obesity. The guideline and accompanying resources for end-users will be published in English and French, and we will partner with Obesity Canada to optimize dissemination using integrated and end-of-project knowledge translation.
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