CONFERENCE ON GUIDELINE STANDARDS

Yale University, New Haven CT

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Abstract

Considerable effort has been dedicated to the creation, dissemination, and implementation of clinical practice guidelines; yet, in many cases, the guidelines initiative has not achieved its potential. Despite the enormous energies invested in guideline authoring, the quality of the products of guideline development has been found repeatedly to be deficient. Critical information that would attest to guideline validity is regularly absent from the published documents. Furthermore, the multiplicity of formats and content poses challenges for those charged with disseminating and implementing guidelines. We believe that a consensus-based standard for guideline content could ameliorate many of these difficulties. This application proposes the convening of a conference to identify current methodological and technical problems in the development of clinical practice guidelines that interfere with their clinical effectiveness and to stimulate a productive interaction among stakeholders. By providing "slots" to fill or checklists for guideline developers to complete, the quality defects that arise from failure to include essential information could be minimized. By offering an agreed upon format for presenting recommendations, ambiguity could be highlighted (and corrected) and guideline implementability could be facilitated. Conference participants, representing a wide diversity of backgrounds and interests, will engage in a modified Delphi consensus process to identify appropriate and necessary guideline content. In addition, the participants will consider optimal approaches to representation of guideline recommendations. The product of the conference will be a draft standard for guideline content that is intended to promote guideline quality and implementability. Application of this standard could improve the comprehensiveness and usability of guidelines and facilitate dissemination and implementation activities.