TY - JOUR
T1 - Bringing two worlds closer together: a critical analysis of an integrated approach to guideline development and quality assurance schemes
AU - Piggott, Thomas
AU - Langendam, Miranda
AU - Parmelli, Elena
AU - Adolfsson, Jan
AU - Akl, Elie A.
AU - Armstrong, David
AU - Braithwaite, Jeffrey
AU - Brignardello-Petersen, Romina
AU - Brozek, Jan
AU - Gore-Booth, Jolanta
AU - Follmann, Markus
AU - Leś, Zbigniew
AU - Meerpohl, Joerg J.
AU - Neamţiu, Luciana
AU - Nothacker, Monika
AU - Qaseem, Amir
AU - Giorgi Rossi, Paolo
AU - Saz-Parkinson, Zuleika
AU - van der Wees, Philip
AU - Schünemann, Holger J.
N1 - Funding Information: This project was funded by the European Commission (CT-EX2016D289038–102) under the umbrella of the European Commission Initiatives on Breast and Colorectal Cancer (ECIBC and ECICC). The funder supported travel to complete this work and reviewed the final manuscript. Funding Information: Thank you to Dr. Susan Norris and Mariano Tomatis for their contributions to the workshop and discussions. Workshop Participants and Affiliated Organisations (Alphabetical Order): ? Jan Adolfsson, Swedish Agency for Health Technology Assessment and Assessment of Social Services, Sweden ? Elie Akl, American University of Beirut, Lebanon ? David Armstrong, McMaster University, Canada ? Jane Beaumont, independent consultant for accreditation and certification ? Jeffrey Braithwaite, International Society for Quality in Healthcare (ISQua), Australia ? Romina Brignardello-Petersen, McMaster University, Canada ? Jan Brozek, McMaster University, Canada [online participation] ? Markus Follmann, German Cancer Society, Germany ? Paolo Giorgi Rossi, Inter-institutional Epidemiology Service, Reggio Emilia, Italy ? Jola Gore Booth, EuropaColon [patient representative], United Kingdom ? Zbigniew Les, EvidencePrime/GRADEpro, Poland ? Miranda Langendam, Department of Clinical Epidemiology, Biostatistics and Bioinformatives, University of Amsterdam ? Joerg J Meerpohl, Medical Center - University of Freiburg, Germany ? Susan Norris, World Health Organisation, Switzerland ? Luciana Neamtiu, JRC, Italy ? Monika Nothacker, Institute of Medical Knowledge Management, Association of the Scientific Medical Societies (AWMF), Germany ? Elena Parmelli, JRC, Italy ? Thomas Piggott, Department of Health Research Methods, Evidence, and Impact, McMaster University ? Amir Qaseem, American College of Physicians, United States of America ? Zuleika Saz-Parkinson, JRC, Italy ? Holger Sch?nemann, Department of Health Research Methods, Evidence, and Impact, McMaster University ? Mariano Tomatis, Freelance IT specialist with a Degree in Computer Science working for hospital quality assurance systems Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Background: Although quality indicators are frequently derived from guidelines, there is a substantial gap in collaboration between the corresponding parties. To optimise workflow, guideline recommendations and quality assurance should be aligned methodologically and practically. Learning from the European Commission Initiative on Breast Cancer (ECIBC), our objective was to bring the key knowledge and most important considerations from both worlds together to inform European Commission future initiatives. Methods: We undertook several steps to address the problem. First, we conducted a feasibility study that included a survey, interviews and a review of manuals for an integrated guideline and quality assurance (QA) scheme that would support the European Commission. The feasibility study drew from an assessment of the ECIBC experience that followed commonly applied strategies leading to separation of the guideline and QA development processes. Secondly, we used results of a systematic review to inform our understanding of methodologies for integrating guideline and QA development. We then, in a third step, used the findings to prepare an evidence brief and identify key aspects of a methodological framework for integrating guidelines QA through meetings with key informants. Results: Seven key themes emerged to be taken into account for integrating guidelines and QA schemes: (1) evidence-based integrated guideline and QA frameworks are possible, (2) transparency is key in clearly documenting the source and rationale for quality indicators, (3) intellectual and financial interests should be declared and managed appropriately, (4) selection processes and criteria for quality indicators need further refinement, (5) clear guidance on retirement of quality indicators should be included, (6) risks of an integrated guideline and QA Group can be mitigated, and (7) an extension of the GIN-McMaster Guideline Development Checklist should incorporate QA considerations. Discussion: We concluded that the work of guideline and QA developers can be integrated under a common methodological framework and we provided key findings and recommendations. These two worlds, that are fundamental to improving health, can both benefit from integration.
AB - Background: Although quality indicators are frequently derived from guidelines, there is a substantial gap in collaboration between the corresponding parties. To optimise workflow, guideline recommendations and quality assurance should be aligned methodologically and practically. Learning from the European Commission Initiative on Breast Cancer (ECIBC), our objective was to bring the key knowledge and most important considerations from both worlds together to inform European Commission future initiatives. Methods: We undertook several steps to address the problem. First, we conducted a feasibility study that included a survey, interviews and a review of manuals for an integrated guideline and quality assurance (QA) scheme that would support the European Commission. The feasibility study drew from an assessment of the ECIBC experience that followed commonly applied strategies leading to separation of the guideline and QA development processes. Secondly, we used results of a systematic review to inform our understanding of methodologies for integrating guideline and QA development. We then, in a third step, used the findings to prepare an evidence brief and identify key aspects of a methodological framework for integrating guidelines QA through meetings with key informants. Results: Seven key themes emerged to be taken into account for integrating guidelines and QA schemes: (1) evidence-based integrated guideline and QA frameworks are possible, (2) transparency is key in clearly documenting the source and rationale for quality indicators, (3) intellectual and financial interests should be declared and managed appropriately, (4) selection processes and criteria for quality indicators need further refinement, (5) clear guidance on retirement of quality indicators should be included, (6) risks of an integrated guideline and QA Group can be mitigated, and (7) an extension of the GIN-McMaster Guideline Development Checklist should incorporate QA considerations. Discussion: We concluded that the work of guideline and QA developers can be integrated under a common methodological framework and we provided key findings and recommendations. These two worlds, that are fundamental to improving health, can both benefit from integration.
KW - Guidelines
KW - Healthcare quality
KW - Quality assurance
KW - Quality improvement
KW - Quality indicators
KW - Recommendations
KW - Tools
UR - http://www.scopus.com/inward/record.url?scp=85101565285&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12913-020-05819-w
DO - https://doi.org/10.1186/s12913-020-05819-w
M3 - Article
C2 - 33627104
SN - 1472-6963
VL - 21
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 172
ER -