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A Reporting Tool for Practice Guidelines in Health Care: The RIGHT Statement
Annals of internal medicine, 2016
The quality of reporting practice guidelines is often poor, and there is no widely accepted guidance or standards for such reporting in health care. The international RIGHT (Reporting Items for practice Guidelines in HealThcare) Working Group was established to address this gap. The group followed an existing framework for developing guidelines for health research reporting and the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach. It developed a checklist and an explanation and elaboration statement. The RIGHT checklist includes 22 items that are considered essential for good reporting of practice guidelines: basic information (items 1 to 4), background (items 5 to 9), evidence (items 10 to 12), recommendations (items 13 to 15), review and quality assurance (items 16 and 17), funding and declaration and management of interests (items 18 and 19), and other information (items 20 to 22). The RIGHT checklist can assist developers in reporting guidelin...
Otolaryngology–Head and Neck Surgery, 2006
G uidelines showcase an organization's ability to create documents of high methodological rigor that facilitate evidencebased decisions. An organization's capacity to influence patient health and public policy-and to preserve autonomydepends largely on the scope, quality, and accessibility of its guideline repertoire. Although there are many approaches to developing guidelines, the authoring process tends to be complex, time consuming, and inefficient. Moreover, the resulting guidelines are often poorly suited to influence care or to assess performance or quality, because the recommendations do not always translate into actions or activities that can be readily implemented and measured. The tested, pragmatic, step-by-step approach outlined herein is based upon the following assumptions and underlying principles: • Guideline development must be systematic, transparent, and evidence-based, yet highly efficient. The goal is to produce high-quality guidelines within 12 months. • Guidelines should contain a series of key, boldfaced action statements that can be used to describe desired behavior, measure performance, and assess quality. Each of these key, boldfaced action statements is followed by text that reviews the supporting research and includes an evidence profile summarizing how the policy was created. Guidelines differ from systematic reviews or meta-analyses, which identify and combine studies but typically do not define action or incorporate values. In contrast, a guideline assigns strengths of recommendation to key action statements based on supporting evidence, harms vs benefits, explicitly defined group values, and patient preference. Guidelines differ from evidence reports, which summarize relevant studies in evidence tables and then combine results, when feasible, using meta-analysis. Evidence reports, often produced by the Agency for Healthcare Research and Quality (AHRQ), are intended to aid in developing clinical practice guidelines and medical review criteria. • Guideline development should be multidisciplinary, even if the authors deal with a specific clinical condition or procedure. The guideline will only possess clout and be widely applicable if it is developed with input from specialists, primary care clinicians, and all other groups with a stake in caring for the patient at any point during the course of a disease, condition, or procedure.
ACCF/AHA Clinical Practice Guideline Methodology Summit Report
Journal of the American College of Cardiology, 2012
Abbreviation List: COR ϭ Class of Recommendation CPG ϭ clinical practice guideline EPC ϭ evidence-based practice center ERC ϭ evidence review committee GRADE ϭ Grading of Recommendations Assessment, Development and Evaluation GWC ϭ guideline writing committee IOM ϭ Institute of Medicine LOE ϭ Level of Evidence PICO(TS) format ϭ (mnemonic: population, intervention, comparator, outcomes, timing, and setting) QOE ϭ Quality of Evidence RCT ϭ randomized controlled trial RWI ϭ relationship with industry and other entities SR ϭ systematic review Full Report 218 Jacobs et al.
PLoS ONE, 2012
Objectives: We conducted a comparative review of clinical practice guideline development handbooks. We aimed to identify the main guideline development tasks, assign weights to the importance of each task using expert opinions and identify the handbooks that provided a comprehensive coverage of the tasks. Methods: We systematically searched and included handbooks published (in English language) by national, international or professional bodies responsible for evidenced-based guideline development. We reviewed the handbooks to identify the main guideline development tasks and scored each handbook for each task from 0 (the handbook did not mention the task) to 2 (the task suitably addressed and explained), and calculated a weighted score for each handbook. The tasks included in over 75% of the handbooks were considered as 'necessary' tasks. Result: Nineteen guideline development handbooks and twenty seven main tasks were identified. The guideline handbooks' weighted scores ranged from 100 to 220. Four handbooks scored over 80% of the maximum possible score, developed by the
CHIEF COMPLAIN. The patient is an alcoholic where the alcohol intake is intense and excessive. He is also a heavy smoker of tobacco and occasionally engages in opium abuse. The patient appeared anxious, sweating with trembling limbs, fingers and a twitching eye. He suffers from malnutrition and kept on complaining about feeling weak with persistent migraine.
The CARE Guidelines: Consensus-Based Clinical Case Reporting Guideline Development
Headache: The Journal of Head and Face Pain, 2013
Background: A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Primary Objective. Develop, disseminate, and implement systematic reporting guidelines for case reports. Methods: We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. Results: This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. Conclusions: We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery.