Clinical and Public Health Guidelines最新文献

{"title":"Comparison between two tools assessing the methodological quality of systematic reviews: ReMarQ and AMSTAR 2","authors":"Manuel Marques-Cruz,&nbsp;Paula Perestrelo,&nbsp;Alexandro W. L. Chu,&nbsp;Sara Gil-Mata,&nbsp;Pau Riera-Serra,&nbsp;Bernardo Sousa-Pinto","doi":"10.1002/gin2.70021","DOIUrl":"https://doi.org/10.1002/gin2.70021","url":null,"abstract":"<p>Several tools are available for assessing the methodological quality of systematic reviews. The ReMarQ tool – centred on the assessment of the reporting methodological quality of systematic reviews – comprises 26 dichotomous items and does not require clinical or background knowledge of the review topic for its application. In this study, we aimed to compare the results of evaluating the methodological quality of systematic reviews using ReMarQ and A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2. We assessed a sample of randomly selected systematic reviews published in medical journals using ReMarQ and AMSTAR 2. We calculated the correlation and agreement between the number of fulfilled items in ReMarQ and the number of (i) fulfilled and (ii) fulfilled or partially fulfilled items according to AMSTAR 2. We assessed 51 systematic reviews using both tools. The number of fulfilled items in ReMarQ was strongly correlated with the number of fulfilled items (<span></span><math></math> = 0.79; 95%CI = 0.65;0.87) and the number of fulfilled or partially fulfilled items (<span></span><math></math> = 0.85; 95%CI = 0.74;0.90) in AMSTAR 2. The percentage of fulfilled ReMarQ items displayed a high agreement with the percentage of fulfilled or partially fulfilled AMSTAR items. In conclusion, the number of fulfilled items in ReMarQ is strongly correlated with that in AMSTAR 2 and there is good agreement between these two tools on the percentage of fulfilled items.</p>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline recommendations can promote or undermine health equity","authors":"Nav Persaud","doi":"10.1002/gin2.70011","DOIUrl":"https://doi.org/10.1002/gin2.70011","url":null,"abstract":"<p>While clinical practice guideline makers and methodologists signal the importance of considering inequities, recommendations often have little or nothing to do with fairness. Since inequities are, by definition avoidable, guidance on clinical practice is a prime opportunity to make health care more fair. Equity should be a central consideration when deciding who to involve in the guideline process, the guideline's scope, the type of information to consider, how to make recommendations and how to share recommendations. Guideline producers should select topics where guidance can actually address inequities and then use information about disparities to make helpful recommendations. Funders and journal editors should insist that guidelines explain how panels were formed and why new guidance on the topic is needed. Changes to clinical practice guidelines will not be enough to promote health equity, but guidelines can be part of the solution if they are thoughtfully produced and acted on by clinicians and by governments.</p>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solving pain points in guideline development and implementation using human-centered design","authors":"Maria Michaels,&nbsp;Chirine Chehab,&nbsp;Mindy Hangsleben","doi":"10.1002/gin2.70014","DOIUrl":"https://doi.org/10.1002/gin2.70014","url":null,"abstract":"<p>Guidelines International Network North America expanded on ‘Adapting Clinical Guidelines for the Digital Age’, an initiative to innovate guideline development and implementation leveraging technology. The objective: solve pain points ̶ problems occurring at different levels of the customer experience ̶ in guideline development and implementation using human-centered design (HCD). In HCD, customers are people who would use the product or system being designed and are at the center of the design process. HCD builds empathy to understand challenges facing different customers. HCD has three phases: inspiration, ideation, and implementation. <i>Inspiration phase</i>: Semi-structured interviews collected multiple perspectives within guideline development and implementation and determined key pain points (38 participants). <i>Ideation phase</i>: HCD workshop ‘Bringing Guidelines to the Digital Age’ defined design goals, determined design criteria, and developed ‘prototype’ solutions for each pain point with feasibility testing during the workshop (35 participants). <i>Implementation phase</i>: Postworkshop participants continued developing and testing solution designs, tracked progress, and created products to be further tested, iterated, or published (44 participants). Interviews revealed five pain points in implementation stemming from issues in guideline development: (1) lack of clarity of ‘how’ to apply recommendations; (2) inadequate or nonexistent feedback and testing; (3) unclear language; (4) incomplete information; and (5) lack of informatics expertise. Each workshop group produced prototypes – early models of products built to test a concept or process – that were consolidated into five solution categories and refined through post-workshop teams focusing on: (1) patient preferences in recommendations (2) real-world testing and feedback, (3) standard operating procedures for computability and better implementability, (4) artificial intelligence approaches, and (5) connecting informatics with guideline development. HCD provided a user-centered, iterative approach to design solutions leveraging technology to solve paint points and improve implementation of guidelines into patient care. This is a blueprint for using HCD in guideline development.</p>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissemination strategies of clinical practice guidelines—mixed methods evidence synthesis protocol","authors":"Sumanth Kumbargere Nagraj,&nbsp;Tandekile Lubelwana Hafver,&nbsp;Ameer Hohlfeld,&nbsp;Emmanuel Effa,&nbsp;Denny Mabetha,&nbsp;Gertrude Kunje,&nbsp;Yan Jiao Shen,&nbsp;Carlos Zaror,&nbsp;Suzgika Lakudzala,&nbsp;Talitha Mpando,&nbsp;Stijn van de Velde,&nbsp;Thomas Agoritsas,&nbsp;Nicolas Delvaux,&nbsp;Per Olav Vandvik","doi":"10.1002/gin2.70012","DOIUrl":"https://doi.org/10.1002/gin2.70012","url":null,"abstract":"<p>Clinical practice guidelines (CPGs) are shared through various dissemination strategies using a range of dissemination products and channels. However, users may have different needs for accessing and understanding them. Patients and carers from low- and middle-income countries might face challenges in accessing CPGs such as inadequate systems for printed book distribution and insufficient and substandard photocopies. Many organizations offer lengthy documents, but busy healthcare workers may prefer shorter, digital versions. Digital CPGs can be sent through different channels such as email, newsletters, or social media. How users feel about these products (e.g., clinical protocol, educational material or decision aids) and how it affects the usage of CPGs is not well understood. In addition to these issues, most of the previous systematic reviews on this topic have clubbed the dissemination strategies along with the adoption of recommendations or implementation aspects. There is a need for evidence on the existing dissemination strategies disentangled from the implementation aspects. We aim to conduct a mixed-methods systematic review to identify documented dissemination strategies for CPGs, barriers and facilitators to access such strategies and the expectations and needs of end users regarding dissemination needs. We will search literature from MEDLINE, Embase, CINAHL, Web of Science, Scopus, Epistemonikos, Agency for Healthcare Research and Quality and Medical Guidelines Clearing house. We will critically appraise all the included studies using appropriate tools based on the study design. We will use manifest content analysis to identify documented dissemination strategies and latent content analysis to understand the barriers, facilitators, preferences of end-users. We intend to follow the convergent matrix model approach for this mixed methods evidence synthesis. We anticipate that this mixed-methods systematic review will highlight the various strategies of dissemination of CPGs and the associated barriers and facilitators.</p>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextualizing guidelines for the health system of Cyprus: Experiences and lessons learnt","authors":"Panayiotis Kouis,&nbsp;Hugh McGuire,&nbsp;Monika Kyriacou,&nbsp;Anneza Yiallourou,&nbsp;Anastasis Sioftanos,&nbsp;Ourania Kolokotroni,&nbsp;Haris Achilleos,&nbsp;Craig Grime,&nbsp;Pilar Pinilla-Dominguez,&nbsp;Giorgos Giallouros,&nbsp;Christina Englezou,&nbsp;Contextualization group,&nbsp;Panayiotis K. Yiallouros,&nbsp;Georgios K. Nikolopoulos","doi":"10.1002/gin2.70013","DOIUrl":"https://doi.org/10.1002/gin2.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cyprus is undergoing a major health reform with the recent establishment of the General Healthcare System (GHS). The GHS offers equal healthcare access through one primary insurer (Health Insurance Organization [HIO]) and benefits from a wide collaborative network of public and private healthcare providers. However, unwanted variation in practice makes this transition challenging. Healthcare guidelines could decrease these variations in practice, but Cyprus lacks the capacity to develop them de novo. Through a collaboration with the National Institute for Health and Care Excellence (NICE) in the United Kingdom, the contextualization of NICE guidelines and the derivation of local quality indicators are carried out. This study presents the methodology and experience of contextualizing the first three NICE guidelines and deriving associated quality indicators in Cyprus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>HIO managed the guideline contextualization with the support of a Guidelines Secretariat. For each guideline, a local topic expert committee (TEC) was recruited. Through a series of meetings, followed by public consultation, each TEC made contextual changes to the guideline and derived relevant quality indicators. During this process, NICE assured quality by overseeing several elements of the contextualization procedure such as TEC membership, proposed changes and justification and derived quality indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2022 and 2024, three NICE guidelines, NG196 on Atrial fibrillation (AF), NG230 on Thyroid cancer (TC) and NG203 on Chronic kidney disease (CKD), were contextualized through the modification of several individual guideline recommendations (21/79 [26.6%] in AF, 37/67 [55.2%] in TC and 62/217 [28.6%] in CKD). In parallel, NICE quality indicators were screened for applicability and feasibility in Cyprus while additional indicators were developed if required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a country with limited experience in guideline development, a supervised and systematic process supported by an established organization ensures quality, is less resource intensive and builds capability for the sustainability of the process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Up-to-dateness of German patient versions of clinical practice guidelines and potential influencing factors: A mixed-methods study","authors":"Irma Hellbrecht,&nbsp;Nadja Könsgen,&nbsp;Dawid Pieper,&nbsp;Barbara Prediger,&nbsp;Jessica Breuing","doi":"10.1002/gin2.70017","DOIUrl":"https://doi.org/10.1002/gin2.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Clinical practice guidelines (CPGs) provide recommendations and are a fundamental part of clinical practice. Many guideline organisations also produce patient versions of CPGs (PVGs). To explore the up-to-dateness of German PVGs, potential methodological influence factors and experts' perspectives, we applied a convergent mixed-methods design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>First, a literature search to identify PVGs was performed between October 2022 and January 2023. We searched the websites of German guideline organisations, Google and the reference lists of included PVGs. We screened the title, downloaded the documents if relevant and retrieved the underlying CPGs and methods reports of CPGs. We aggregated the literature search dates of CPGs and calculated the time between the CPG literature search and PVG publication. Second, interviews with experts in the PVG development were conducted and analysed using qualitative content analysis (Mayring) with MAXQDA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>49 PVGs were included and analysed. A median of 36 months elapsed between the literature search of CPGs and the publication of PVGs. A median of 25 months passed between the literature search and publication of CPGs, and a median of 7.5 months elapsed between the CPG and PVG publication. Six interviews were conducted and interviewees mostly perceived PVGs as up-to-date. However, they identified exceptions in the up-to-dateness depending on the topic or thematic chapters of PVGs. Interviewees mentioned different influencing factors such as the scientific progress and the editorial process of PVGs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings underline potential issues with the up-to-dateness of PVGs. In the context of a fast-moving evidence basis, it seems doubtful whether PVGs actually reflect the current state of knowledge, especially in fields with high research activity. However, some factors may not be modifiable because they essentially contribute to the quality assurance of PVGs. Further research is desirable to investigate possible measures to improve the up-to-dateness of PVGs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient involvement in the development of clinical practice guidelines in Germany—A meta-research study","authors":"Stefanie Pfisterer-Heise,&nbsp;Clara Orduhan,&nbsp;Käthe Goossen,&nbsp;Jessica Breuing,&nbsp;Irma Hellbrecht,&nbsp;Sebastian von Peter,&nbsp;Corinna Schaefer,&nbsp;Dawid Pieper","doi":"10.1002/gin2.70016","DOIUrl":"https://doi.org/10.1002/gin2.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patient involvement (PI) is a key element of clinical practice guidelines (CPGs). However, PI in CPGs often falls short of quality standards. For evidence- and consensus-based CPGs in Germany, a study in 2018 showed that a mere 58% had included a patient (participation), 56% with voting right. We aimed to provide an update on whether and how patients were involved in CPGs (participation and consultation), on the availability of patient versions (PVGs) (communication) and to investigate whether CPGs in Germany adhere to the RIGHT checklist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An electronic search on the Register of the Association of Scientific Medical Societies was performed. Eligibility criteria were defined a priori. We included evidence- and consensus-based CPGs valid on 31 March 2023. A data extraction form including 35 items was designed and piloted. Five researchers independently extracted data from CPGs, methodology reports and PVGs. Data were analysed descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search identified 135 CPGs meeting the eligibility criteria. Participation has increased to 79% (107/135 CPGs), in 73% of CPGs (98/135) with voting right. Participation was more common in CPGs for chronic than acute conditions (76/86 CPGs, 88% chronic vs. 23/38 CPGs, 61% acute). Consultation was scarcely employed (3/135 CPGs, 2%). Communication, operationalised as PVGs being available on the internet, increased from 33% (35/105) in 2018 to 43% (58/135) in 2023. 26% of CPGs (28/107) with participation reported on patients' selection as required by the RIGHT checklist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>PI has improved, although around 20% of CPGs were still developed without participation. This applies in particular to CPGs on acute conditions where PI should be strengthened. At the same time, innovative and efficient methods for consultation and for evaluating patients' impact are required. Moreover, communication should be expanded. To further improve transparency in CPGs, guideline development groups should specifically report on patients' recruitment and selection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing health equity: Why guideline development must prioritize fairness and justice","authors":"Omar Dewidar,&nbsp;Jordi Pardo Pardo,&nbsp;Juan Pablo Peña-Rosas,&nbsp;Rebecca Thomas,&nbsp;Vivian Welch,&nbsp;Peter Tugwell","doi":"10.1002/gin2.70015","DOIUrl":"https://doi.org/10.1002/gin2.70015","url":null,"abstract":"<p>Health equity should be regarded as a fundamental principle and a priority for all guideline development organizations. Yet, this principle has not been consistently prioritized in the creation of mainstream guidelines. In this commentary, we examine a real-world example from leprosy management, where the initial lack of integration of health equity considerations in the guideline recommendations did not consider the potential impact of the recommendations on the health of populations most affected by leprosy. We also highlight subsequent changes in the guideline development process that reflect stronger consideration of health equity, addressing some of the previous issues propagated with historical practices. We also draw on other examples from several fields to further illustrate the impact of integrating health equity considerations in guidelines. Building on evaluations of guidelines for health equity and real-world experiences, we highlight some of the common challenges in integrating health equity considerations in the guideline development process. We propose potential solutions using existing tools and frameworks and outlining key research priorities to further advance this goal.</p>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The paradox of implementation: Tools without impact - reflections from the global evidence summit","authors":"Laura Mora Moreo","doi":"10.1002/gin2.70010","DOIUrl":"https://doi.org/10.1002/gin2.70010","url":null,"abstract":"&lt;p&gt;The Global Evidence Summit (GES2024), held in Prague from September 9 to 13, 2024, united scholars, healthcare professionals, and policymakers to tackle global health challenges. Among the diverse topics presented, implementation science stood out, emphasising collaboration to bridge evidence and practice gaps while fostering discussions on improving health systems and outcomes. Notably, many talks and posters focused on implementing clinical guideline recommendations—a critical and growing area of interest. However, a paradox remains: &lt;i&gt;whilst the development of implementation tools is on the rise, their actual influence on clinical outcomes remains largely unquantified&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;The GES2024 presented numerous presentations on digital technologies, decision-support systems, and other advanced tools for disseminating and implementing clinical guidelines. For example, one exhibit showcased a mobile app designed to integrate palliative care guidelines into daily practice through a web-based platform for healthcare professionals. Despite their popularity and high levels of user engagement, evidence of these innovations' effectiveness in improving patient outcomes was limited. Many implementation tools gauge success through superficial metrics like downloads or user engagement, which primarily reflect conceptual use,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; while these metrics indicate awareness or understanding, they rarely lead to the behavioural or process changes characteristic of instrumental use. For meaningful and sustained impact, such efforts must progress beyond these surrogate outcomes to measurable clinical outcomes that directly improve patient care or system efficiency, aligning with the goals of knowledge translation and implementation science. For example, the palliative care platform received over 100,000 visits in its first 6 months, but data on patient impact were lacking. Measuring app downloads is different from evaluating their effect on patient outcomes. While high engagement numbers suggest interest, they do not indicate whether the guidelines improved patient care or symptom management.&lt;/p&gt;&lt;p&gt;This raises a critical question: &lt;b&gt;Are implementers failing to recognise the importance of measuring the true impact of these tools, or are clinical guidelines recommendations inherently difficult to assess in real-world practice?&lt;/b&gt;&lt;/p&gt;&lt;p&gt;The literature emphasises that focusing only on engagement without assessing clinical outcomes undermines the main goal of guidelines—improving patient care. There is still a significant lack of information about the effective implementation of these recommendations. Despite existing frameworks, there is a shortage of evidence about real-world application and effectiveness. Research shows a persistent gap between creating guidelines and putting them into practice, often worsened by inconsistent adaptation across different contexts. This underscores the need for strong research methods to determine whether guide","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143119510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the GRADE-ADOLOPMENT framework in developing the Philippine national screening guideline recommendations","authors":"Ian Theodore G. Cabaluna,&nbsp;Maria Vanessa C. Villarruz-Sulit,&nbsp;Katelyn Edelwina Y. Legaspi,&nbsp;Leonila F. Dans","doi":"10.1002/gin2.70008","DOIUrl":"https://doi.org/10.1002/gin2.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preventive health screening is an important strategy in improving health outcomes of the general population and sustaining universal healthcare initiatives. Due to the large resource requirement, we used the GRADE ADOLOPMENT framework to synthesize the evidence and develop recommendations for preventive health screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Our objectives were to describe the development and feasibility of a national preventive screening practice guideline using the GRADE-adolopment process and to discuss the methodological process, contextual differences from the source guidelines, and the resulting changes to the final recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multidisciplinary team was convened. We used the GRADE-ADOLOPMENT and Evidence-to-Decision (EtD) framework in synthesizing the evidence and developing the recommendations. Evidence from the World Health Organization, United States Preventive Services Task Force, and Canadian Task Force on Preventive Healthcare were used. Values and preferences of the guideline developers were incorporated through the EtD framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>In 6 months, we developed 16 evidence summaries and developed 23 recommendations for 16 prioritized conditions. Thirteen recommendations were adopted. Four recommendations were modified to address contextual differences. Six recommendations were developed de novo due to either lack of evidence or differences in values and preferences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The GRADE-adolopment framework was a feasible and efficient framework in adopting guidelines on preventive screening. The EtD framework improved the transparency and highlighted areas to consider in making recommendations for the Philippine context. Challenges encountered were insufficiency of local evidence, and the lack of experience and skills in interpreting and analyzing the evidence especially on screening strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100266,"journal":{"name":"Clinical and Public Health Guidelines","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gin2.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}