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An adapted 'Ottawa' method allowed assessing the need to update topic areas within clinical practice guidelines
Käthe Goossen1, Dan Bieler2, Simone Hess1
1Institute for Research in Operative Medicine (IFOM), Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany.
Journal of Clinical Epidemiology
|June 16, 2022
Summary
The modified Ottawa method efficiently identifies evidence updates for medical guidelines. This tool helps determine when guideline topic areas need revision, ensuring patient care reflects current medical knowledge.
Area of Science:
- Medical guideline development
- Evidence-based medicine
- Health services research
Background:
- Clinical practice guidelines require regular updates to reflect the latest evidence.
- Assessing the need for updates across multiple recommendations within a guideline topic area is complex.
- The original Ottawa method identifies evidence changes for individual guideline questions.
Purpose of the Study:
- To adapt the Ottawa method for assessing the need to update entire guideline topic areas.
- To evaluate the modified method's efficiency and suitability in a real-world setting.
- To gather feedback from guideline developers on the adapted method.
Main Methods:
- Adapted the Ottawa method to aggregate updating signals by topic area.
- Applied the modified method to the German guideline on severe/multiple injury treatment.
- Conducted focused literature searches and systematic evidence evaluation for 37 topic areas.
- Surveyed guideline group members on their experience with the modified method.
Main Results:
- A need to update was identified as high for 21.6%, intermediate for 21.6%, and low for 56.8% of topic areas.
- The literature search screened an average of 97 abstracts per topic area.
- 94% of surveyed guideline group members indicated willingness to use the method again, despite noting some weaknesses.
Conclusions:
- The modified Ottawa method is an efficient, evidence-based tool for signaling updates needed in guideline topic areas.
- The method facilitates the systematic assessment of evidence changes across multiple recommendations.
- Further refinement of the adapted Ottawa method is recommended for optimal implementation.
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