Needs assessment for updating IOM standards for trustworthy clinical practice guidelines

Abstract

Background

The Institute of Medicine (IOM) Standards for Clinical Practice Guidelines We Can Trust (CPG Standards) and Standards for Systematic Reviews (SR Standards), established in 2011, have significantly influenced evidence-based healthcare. However, the rapid evolution in medical practices and technologies necessitates a reassessment of these standards to ensure their continued relevance and effectiveness in modern healthcare.

Methods

This study employed a survey approach targeting professional guideline developers. The first survey assessed the general need for updating IOM standards (both CPG and SR Standards), while the second focused on specific CPG Standards, soliciting detailed feedback on their current relevance and areas needing revision. Participants were purposively targeted from various medical specialties and roles in guideline development.

Results

The General Need for Updating IOM Standards Survey garnered 22 responses, and the Specific CPG Standards Survey received 25 responses. A significant majority of respondents indicated the need for revising both the CPG and SR Standards. Key areas identified for CPG standards revision included conflict-of-interest management, incorporation of real-world evidence and artificial intelligence, and systematic review processes. The responses highlighted the challenges of high compliance costs and the need for more practical execution guidance.

Conclusion

This study highlights an urgent need for updating both sets of IOM Standards. The rapidly changing healthcare landscape, characterized by technological advancements and evolving medical evidence, necessitates a dynamic and responsive approach to guideline development. Establishing an authoritative body for periodic assessment and revision of these standards is crucial to ensure that CPGs remain scientifically robust, practical, and relevant to contemporary healthcare needs.