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# List of tables
. Possible actions following disclosure of potential conflict of interest................ Table 3. Overview of the processes and timelines for active topics.............................. Table 4. Summary of knowledge translation evaluation activities................................

# A R C H I V E D Preface
This document replaces the first edition of the Procedure Manual, published in October 2011, and is intended for use by members of the Canadian Task Force on Preventive Health Care, the Evidence Review and Synthesis Centre, and the Prevention Guidelines Division of the Public Health Agency of Canada in the development of recommendations. This manual may also be useful for other organizations that are developing evidence-based guidelines.

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# Overview of the Canadian Task Force on Preventive Health Care
The mandate of the Canadian Task Force on Preventive Health Care (CTFPHC) is to develop clinical practice guidelines (CPGs) that support primary care providers in delivering preventive health care.
The CTFPHC uses the same definition of primary care as the US Institute of Medicine:
Primary care is the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community (p. 31).

# Structure and Function
The CTFPHC is an independent panel, composed primarily of clinicians and methodologists, that makes recommendations for clinical preventive services based on rigorous, systematic review and synthesis of evidence conducted by the Evidence Review and Synthesis Centre (ERSC). The CTFPHC makes recommendations directly to its key constituency of primary care providers, but its work is also directly relevant to other health care professionals, developers of preventive care programs, policy-makers, and Canadian citizens. It uses standardized methodology and transparent processes to review and synthesize evidence, to weigh the balance of benefits and harms, and to make recommendations. The CTFPHC also develops and fosters linkages between primary care and community or public health programs that support clinical preventive services, as well as linkages to enhance the dissemination and uptake of its recommendations. Finally, the CTFPHC works with researchers to advance the evidence base supporting preventive care.
The recommendations of the CTFPHC are aimed at improving clinical practice and promoting public health. The CTFPHC provides recommendations about primary and secondary preventive services targeting clinically relevant conditions. The services must be provided in primary care settings or available through primary care referral. Primary prevention is the prevention of a target condition in healthy patients and takes the form of activities such as counselling and chemoprevention. Secondary prevention is directed to asymptomatic individuals who have risk factors for a condition or preclinical disease but who do not have clinically evident disease.
The CTFPHC has independent decision-making authority in all aspects of its scientific mission, including the following activities:
- final decisions about topics to be covered - setting of standards and expectations for review and synthesis of the evidence - development, public declaration, and dissemination of its recommendations
The CTFPHC contributes to improvements in the quality of health care by:
- systematically reviewing the evidence for the effectiveness of preventive interventions in personal health care - producing high-quality evidence-based guidance for primary care practitioners A R

# C H I V E D
- producing evidence-based recommendations for clinical preventive interventions - identifying gaps in current knowledge in clinical preventive care - focusing on health issues and interventions that will have the largest impact in improving the health of Canadians - being a source of expert knowledge independent of government policy 1.4 Overview of roles 1.4.1 Role of the CTFPHC The CTFPHC is responsible for prioritizing the topics that will be reviewed and works with the Office of the CTFPHC (TFO) at the Public Health Agency of Canada (PHAC) to define the analytic framework and scope of each topic. The CTFPHC works closely with the ERSC and the TFO in preparing systematic reviews and developing recommendations for each topic. The CTFPHC is also primarily responsible for leading knowledge translation (KT) and dissemination activities and assists key stakeholders in designing and implementing an evaluation strategy to assess the impact of the CTFPHC's products.

# Role of the TFO
The TFO at the PHAC provides scientific support to the CTFPHC. A scientific research manager is assigned for each topic, and this person coordinates and provides scientific support during development of the systematic reviews and recommendations for the topic. A scientific research manager also serves as the co-chair of the various working groups of the CTFPHC.

# Role of the ERSC
The ERSC conducts the systematic reviews that are used as the basis for the CTFPHC's recommendations. The ERSC follows documented methods for its reviews of the topics specified by the CTFPHC and follows the methods of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group 2 in assessing the evidence.

# Role of the University of Alberta
PHAC and the University of Alberta signed a Contribution Agreement in 2012, with the aim of enhancing the CTFPHC's ability to disseminate its recommendations to primary care practitioners. Under the agreement, the university provides KT, stakeholder engagement, evaluation, and administrative support to the CTFPHC.
The TFO will periodically solicit nominations for new members of the CTFPHC, including the chair and vice-chair, by contacting stakeholder groups and through other appropriate channels. Both new and previous nominations will be considered. Nominations may also be submitted by current members of the CTFPHC. Once one or more individuals have been nominated, the CTFPHC appoints a selection committee composed of the current chair and vice-chair of the CTFPHC, two other current members of the CTFPHC, one representative of PHAC, and one external representative appointed on a rotating basis by the chair and vicechair of the CTFPHC. The selection committee reviews the qualifications of each nominee in relation to the required qualifications for selection (Table 1) and makes its recommendations for appointments directly to the CTFPHC, which votes on the recommendations. The Joint Appointment Committee (consisting of the Chief Public Health Officer and a representative from the College of Family Physicians of Canada then reviews and approves the recommendations. After approval, new members are appointed to the CTFPHC.

# A R C H I V E D Table 1. Qualifications for appointment to the CTFPHC
National and international recognition in respective field of expertise Knowledge and experience in critical appraisal of peer-reviewed publications Knowledge and experience in systematic review methods Knowledge and experience in applying evidence to decision-making or policymaking Expertise in disease prevention and health promotion Demonstrated ability to collaborate with peers No conflict of interest (including financial or intellectual conflicts) that would impair the integrity of the CTFPHC Expertise in methodology (e.g., medical decision-making, clinical epidemiology, health economics) Adapted from the procedure manual of the US Preventive Services Task Force. 3

# Selection of chair and vice-chair
The selection committee makes a recommendation for the chair of the CTFPHC to the Joint Appointment Committee, who appoints the chair. In turn, the chair makes a recommendation for the vice-chair, on the basis of discussions with the Joint Appointment Committee, which then appoints the vice-chair.

# Selection of members
For the inaugural membership of the CTFPHC, the selection committee made recommendations for individual members to the Joint Appointment Committee, which subsequently appointed the new members. When additional members are needed, the selection committee will make recommendations according to the criteria listed in Table 1. Individuals recommended for membership must be ratified by a majority vote of current members of the CTFPHC and are then appointed by the Joint Appointment Committee.

# Terms of service
The CTFPHC consists of 12 to 16 voting members, consisting of 10 to 14 members, one vice-chair, and one chair. The initial term for each member, including the chair and the vicechair, is three years, with a possible one-year extension. The extension of terms will be staggered, to ensure continuity of membership over time and overlap of terms. When members leave the CTFPHC, they are expected to continue keeping all CTFPHC business confidential. As members rotate off the CTFPHC, they are offered the opportunity to continue working on guidelines that are already under way. Working group chairs are asked to remain available for consultation about the need for updates on their topics for one year after their terms are complete.

# Non-voting members of the CTFPHC
The chair may assign ex officio members to support the work of the CTFPHC.
The Director of the TFO will sit as a non-voting member of the CTFPHC. Scientific staff at the TFO are not official CTFPHC members but work with the CTFPHC through all stages of the guideline development process

# Quorum and voting
A quorum for official votes is two-thirds of the members, including the chair. Major decisions about procedures and methods, recommendations, clinical practice statements, and the A R C H I V E D selection of new members all require a non-secret vote. Votes are taken by hand, by voice, or by proxy, and voting can be done electronically if necessary (e.g., if a quorum is not available during an in-person meeting). Members with a potential conflict of interest related to the topic of a particular vote must recuse themselves and are not eligible to vote. Votes are recorded as yes, no, abstain, or absent. In cases where a decision is not unanimous, no minority reports are permitted.