“Living guideline recommendations” – more important than ever?! Successes and challenges of “living guidelines”: A systematic evaluation

IF 1.7 Q4 HEALTH POLICY & SERVICES

Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen Pub Date : 2025-07-01 DOI:10.1016/j.zefq.2025.05.003

Monika Nothacker, Jordana Dreger, Ina Kopp, Susanne Blödt

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引用次数: 0

Abstract

Introduction

The development of high-quality guidelines is resource-intensive and time-consuming, and currency is crucial for the improvement of care. Criteria-based update procedures are recommended. Living guidelines (LGs) are intended to quickly incorporate new findings. The guidance of the Association of the Scientific Medical Societies in Germany (AWMF) require an annual review and needs-based updating. Internationally, there are different definitions; in particular, the concept of “living recommendations” based on “living systematic reviews” is recommended.

Methods

A search for LGs (March – May 2024) was carried out in the AWMF guideline registry, Medline and three international guideline databases to compare current German and international LGs based on criteria of an LG framework concept and to identifiy favorable and unfavorable implementation factors.

Results

Few current guidelines – 12 German and 26 international – followed a “living” concept. Decisions for German LGs were mostly made per project, internationally mostly at the organisational level. Compared to international LGs, German LGs had more recommendations, with less evidence-based content, and a lower research and update frequency. Not all LGs had a transparent methodological documentation with labelling of new, amended, or confirmed recommendations. More international than German LGs are available in apps with direct access to recommendations.

Discussion

The “Living Guideline” concept is rarely implemented, and the approach continues to vary. During the COVID-19 pandemic, resources and motivation were high. Currently, organizational support in combination with a rather narrow guideline scope seem to offer the best conditions for LGs.

Conclusion

We need current and trustworthy guidelines. Actual concepts provide different opportunities. To support them, decisions should also be made at the organizational level.

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“生活指南建议”——比以往任何时候都重要？！“生活指南”的成功与挑战：系统评价。

导言：制定高质量的指南需要耗费大量资源和时间，而资金对于改善护理至关重要。建议使用基于标准的更新过程。生活指南（LGs）旨在快速纳入新的发现。德国科学医学学会协会（AWMF）的指导要求每年进行一次审查，并根据需求进行更新。国际上有不同的定义；特别推荐基于“生活系统评价”的“生活建议”概念。方法：在AWMF指南登记处、Medline和三个国际指南数据库中检索LGs（2024年3月至5月），根据LG框架概念的标准比较当前德国和国际LGs，并确定有利和不利的实施因素。结果：目前很少有指南（12份德国指南和26份国际指南）遵循“生活”概念。德国LGs的决策大多是在每个项目上做出的，而国际上主要是在组织层面上做出的。与国际LGs相比，德国LGs的建议更多，基于证据的内容较少，研究和更新频率较低。并不是所有的研究组都有一个透明的方法文档，其中标注了新的、修订的或确认的建议。在应用程序中，比德国的LGs更国际化，可以直接访问推荐。讨论：“生活指南”概念很少得到实施，方法也在不断变化。在2019冠状病毒病大流行期间，资源和动力都很高。目前，组织支持与相当狭窄的指导范围相结合似乎为LGs提供了最好的条件。结论：我们需要最新的、值得信赖的指南。实际的概念提供了不同的机会。为了支持他们，还应该在组织一级作出决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen HEALTH POLICY & SERVICES-

CiteScore

1.90

自引率

18.20%

发文量

129