A Framework for the Development of Living Practice Guidelines in Health Care

Area of Science:

• Health Services Research
• Evidence-Based Practice
• Guideline Development Methodologies

Background:

• Living practice guidelines are essential for incorporating rapidly emerging evidence into healthcare recommendations.
• Existing methods for developing these dynamic guidelines require a structured framework for consistency and responsiveness.

Purpose of the Study:

• To develop a comprehensive framework characterizing the processes involved in creating living practice guidelines within healthcare.
• To provide a standardized approach for the planning, production, reporting, and dissemination of living guidelines.

Main Methods:

• Conducted three background reviews: scoping of methods papers, review of guideline organization handbooks, and analytic review of existing living guidelines.
• Drafted an initial framework based on review findings.
• Refined the framework through international stakeholder engagement, including online surveys and discussions.

Main Results:

• A key principle is that individual recommendations are the unit of update in living guidelines.
• The framework details planning, production (initiation, maintenance, retirement), reporting (evidence surveillance, reassessment, recommendation revisiting), and dissemination processes.
• Reporting includes crucial elements like evidence surveillance timestamps and outcomes of reassessment and recommendation reviews.

Conclusions:

• The developed framework offers a structured approach to living guideline development, enhancing responsiveness to new evidence.
• It will assist guideline developers in managing projects and support research methodologists in studying living guideline processes.
• While providing a conceptual structure, the framework does not offer detailed implementation guidance.