The ESCMID framework for reaching consensus in clinical guidelines

Area of Science:

• Clinical Microbiology and Infectious Diseases
• Guideline Development Methodologies

Background:

• The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) requires methodological standardization for its expanding guidelines program.
• Existing consensus methods in guideline development need formalization and consistent application.

Purpose of the Study:

• To develop a standardized framework for consensus methods within ESCMID guideline panels.
• To enhance the quality, transparency, and consistency of ESCMID guidelines.

Main Methods:

• Conducted two scoping reviews: one on formal consensus methods in guideline development (PubMed) and another on practical operationalization of consensus by guideline organizations.
• Synthesized findings using descriptive and narrative analyses, integrating them with ESCMID's approach and feasibility.
• Incorporated stakeholder review and revisions before final approval by ESCMID governance.

Main Results:

• Developed a standardized framework for consensus in ESCMID guideline panels.
• Mandatory anonymous voting with ≥80% agreement for recommendations is central.
• Framework details voting rights, participation, standardized options, outcome reporting, and procedures for non-responsiveness and lack of consensus.

Conclusions:

• The new framework advances ESCMID's guideline development process.
• Enhances quality, transparency, consistency, and reduces bias in ESCMID guidelines.
• Strengthens the trustworthiness of ESCMID clinical guidelines through methodological rigor.