bluuebunny/crossref_metadata_2025_split huggingface dataset:
P311 A Survey On The Likely Resources Of Guideline Dissemination And The Perceived Barriers To The Utilization In Korea
Authors: Shin E , Jo H , Lee S , Chang S , Oh M 
Published: August 2013

BackgroundDissemination resources are very important to utilise Guidelines. To provide useful information to make a strategy for promoting implementation effectiveness, identifying the barriers to the utilisation should be done.ObjectivesTo identify the likely resources of guideline dissemination and find out the barriers to the utilisation of a clinical practice guideline in Korea.MethodsLikely resources of dissemination and the perceived barriers to the utilisation of a clinical practice guideline for sexually transmitted infections which is developed in 2011 by The Korean Urological Association were surveyed using structured questionnaire by e-mailing to physicians working at primary health care clinics from 1st Nov – 30thNov 2012. Total number of respondents was 305 and the response rate was 6%.ResultsThere were various likely resources of a guideline dissemination; the most likely resource was a printed full version guideline (76.3%), followed by web and mobile application (Guideline APP) (65.6%) and learning modules such as workshop (51.5%). Barriers to the utilisation of clinical practice guideline were ‘not knowing because of the improper promotion’, ‘unclear compensatory mechanisms like the fee schedule for practice guidelines’, and ‘insufficient treatment time to check the recommendation of practice guidelines’.DiscussionTo maximise guidelines dissemination benefits, various resources should be provided at the same time. The current surveyed knowledge of barriers may be very important information for implementing guidelines.Implications for Guideline Developers/UsersIdentifying resources of dissemination and understanding barriers to the utilisation is important for development efficient tailor-made implementation strategies.
P314 Barriers And Facilitators To The Implementation Of Clinical Practice Guidelines: A Survey Among Physicians In Specialized Care
Authors: Reviriego E , Iruretagoyena M , Arcelay A , Villanueva G 
Published: August 2013

BackgroundIn an era when an increasing amount of clinical information is available to health care professionals, the effective implementation of clinical practice guidelines requires the development of strategies to facilitate the use of these guidelines.ObjectivesExplore the knowledge and attitudes of Specialised Care Physicians (SC) in terms of the use of CPGs; identify the barriers and facilitators to their proper dissemination and implementation; identify the strategies and actions for improvement that contribute to minimising the impact of the barriers that have been detected.MethodsWe conducted a survey in order to assess resources, knowledge and attitudinal barriers of physicians working in Specialised Care towards the Clinical Practice Guidelines.ResultsThe questionnaire was completed by 209 SC physicians. The application of the recommendations in the CPGs is considered to be easy by 61.2% of participants, while 28.2% considered this procedure to be difficult. Among the reasons behind the difficulty were: the complicated nature of practical application, the lack of organisational, financial and infrastructure-related resources, the variable nature of the patients, the lack of time, little evidence with low-quality recommendations, disagreement, a lack of interest and motivation and the lack of knowledge of the CPGs due to unsatisfactory dissemination.ConclusionInformed by the results of the survey, leading health authorities are making an effort to develop specially designed interventions to implement clinical practice guidelines, including an easily accessible online database.
P317 Implementation Of Evidence Based Healthcare And Guidelines In Clinical Practice
Authors: Steinhausen K , Slordahl S 
Published: August 2013

BackgroundHealthcare received by Europe’s citizens should be based on the best scientific evidence and with involvement of patient and public. Greater emphasis on scientific evidence for a health intervention must be thoroughly analysed, health technology assessment (HTA) must become a cornerstone of healthcare. We have discussed these issues with different interdisciplinary groups and published two strategic papers in 2011 and 2012.ObjectivesThe aim is to present and discuss further possible implementation steps for improving implementation of evidence based healthcare and guidelines in clinical practice.MethodsIn 2011 and 2012 workshops with interdisciplinary working groups (knowledge transfer, patient involvement and general practice) took place. Needs for actions and the relevant stakeholders were identified.ResultsNeeds for action: Establish a European Institute for Health Research where common issues in European healthcare research and policy can be debated and appropriate strategies formulated. Organise meetings between HTA/EBM leaders and policy-makers and health administrators on the European, national, regional and local level Establish at national level Healthcare Knowledge Centres for improved access to and transfer of unbiased information on patient-oriented research Set up research networks and ensure collaborative research between primary and secondary care Develop incentive systems for using and implementing evidence-based practice, guidelines and policy at medical care level through national European guidelines or even regulations and the relevant stakeholders.DiscussionIt is now important to implement these needs. The involvement of different stakeholders from research, clinical practice, regulation, policy, patients and the public is urgently needed.
P319 Minds Project As Guideline Clearinghouse - Evaluation Of Clinical Practice Guidelines Developed In Japan
Authors: Okumura A , Yoshida M , Kiyohara K , Takahashi N , Hatakeyama Y , Htun N , Sato Y , Kojimahara N , Yamaguch N 
Published: August 2013

BackgroundMINDS (Medical Information Network Distribution Service) is a consignment project for MHLW (Ministry of Health, Labour and Welfare) managed by Japan Council for Quality Health Care. MINDS has been disseminating evidence-based clinical practice guidelines (CPG) as guideline clearinghouse in Japan.ObjectivesTo assess the quality of evidence-based CPG developed in Japan.MethodsWe searched Japanese CPG using 10 major databases from January 2007 to January 2013. After two-stage screening process with exclusion criteria, identified CPG were evaluated by 4 reviewers of the CPG evaluation group using the AGREEII (Appraisal of Guidelines for Research & Evaluation II) Instrument.ResultsA total of 1763 literatures were identified by the searching process. After screening process, 168 guidelines were evaluated by the AGREEII instrument from September 2011 to January 2013. The scores mean (SD) of each AGREEII domain were as follows: Scope and Purpose, 64.1 (19.2); Stakeholder Involvement, 46.0 (18.2); Rigour of Development, 39.8 (24.6); Clarity of Presentation, 58.8 (21.3); Applicability, 42.7 (16.3); Editorial Independence, 29.9 (31.4) and Overall assessment, 50.4 (21.1).DiscussionAmong the AGREEII domains, Editorial Independence and Rigour of Development are important factors to improve the quality of Japanese CPG.Implications for guideline developers/usersIt is necessary to cooperate with guideline development group in order to utilise the guidelines evaluation result for improving the guideline development process. MINDS is preparing to hold workshops 2013 focused on guideline methodology for guideline developers.
P321 Dissemination Of The Clinical Practice Guidelines Development Methodology Based On body Of Evidence In Japan ∼ Development Of Educational Package For Clinical Practice Guidelines And Workshop Program
Authors: Yoshida M , Hatakeyama Y , Okumura A , Takahashi N , Kojimahara N , Kiyohara K , Sato Y , Htun N , Yamaguchi N 
Published: August 2013

ObjectiveThe dissemination and active support for clinical practice guidelines development method based on the principle of EBM, is one of the main pillars of MINDS (Medical Information Network Distribution Service) consignment project for EBM promotion implemented by Ministry of Health, Labour and Welfare Japan. In 2007, with the publication of MINDS guidance to develop Clinical practice guidelines 2007 by Fukuiet al., a protocol to develop clinical practice guidelines was introduced as the most valid manual at that time in Japan. However, advanced improvements towards the global standards in the CPG development methodology have been established within these 5 years after previous publication, such as GRADE system, AGREE II, IOM etc. Accordingly, the Workshop for Clinical Practice Guidelines development methodology is planned to introduce the latest advanced methodology for medical and healthcare professionals who engaged in the clinical practice guidelines development. 2. Contents This workshop comprises the lectures and group practices, assuming AGREE II as a standard for the educational package development and, using GRADE system for quality of evidence and strength of recommendation, which promote the CPG development methods for disease management. We hope to show the ‘PROGRAMME’ for the progress of the workshop at G-I-N2013. 3. Target Audience For all medical and healthcare professionals who have interest in and for those who engage in clinical practice guidelines development in Japan. 4. Workshop Outline Educational workshops will be held four times within a year 2013 in Tokyo Japan. The first workshop date: 2013-03-20 (Wed) 10:00∼17:00
P327 Overview of Clinical Practice Guidelines in Japan - From The Point Of View Of Patient-Involvement
Authors: Suzuki H 
Published: August 2013

BackgroundIn Japan, the official movement to develop Clinical Practice Guidelines (CPGs) began in 1999 with the financial support of the Ministry of Health, Labour and Welfare -MHLW). Since then, CPGs in various fields have been developed and development methods using the principles of evidence-based medicine are becoming popular.ObjectivesThe First objective of the study is to clarify how many CPGs developed and published in Japan in 2013. The second is to make clear if patient-involvement is popular or not.MethodsI have searched the existing CPGs comprehensively. Out of the 600 searched CPGs, well-formulated ones were selected if they met the following criteria: defining clinical questions to be addressed, reviewing evidence, determinig grade of recommendation, and becoming open to the public. I have checked public involvement in developing.ResultsNevertheless 120 CPGs are selected, the number of CPGs, containing patient/carer member in developing process, is only 6. And the number of patient-version CPGs is only 29.DiscussionA reason why the patient-involvement doesn’t become popular, came from MHLW decision, stopping the financial support in 2004. This decision resulted in the view that individual professional societies were required to develop CPGs applicable to those topics related to their societies. Accordingly, a given professional society, which should always be involved in the CPG development group as one of the main stakeholders, was the sole party involved in the development of CPGs.
P329 Developing A Strategy To Assess The Reporting Of The Updating Process In Clinical Practice Guideline: A Draft Checklist
Authors: Vernooij R , Sanabria A , Martínez García L , Makarski J , Brouwers M , Alonso-Coello P 
Published: August 2013

BackgroundScientific knowledge is in constant change and, therefore, clinical practice guidelines (CPGs) require a frequent reassessment. However, the best methodology for updating CPGs is not known and methods are poorly reported in CPGs. A framework to evaluate the quality of reporting the updating process in CPGs and to provide guidance for minimum thresholds for an updating strategy is needed.ObjectiveTo develop a CPG update reporting checklist.MethodsAn initial list of items has been developed based in a systematic review done for our team about the guidance in updating handbooks. The working group has reviewed the initial list and reached consensus about the items to include. Through a survey, we will present the initial list to a multidisciplinary group of international experts and we will ask them about what is the relevant information that needs to be reported in an updated CPG, and about the elements to be included in a high-quality updating process.ResultsThese results will give us insight in what elements are required to be reported an updated CPG. Additionally, we will gain information about what kind of elements include a high-quality updating process.Discussion and ImplicationsThis checklist will help people responsible for updating CPGs, in conducting and reporting their update in a high-quality manner. Ultimately this might results in more up-to-date recommendations and more valid CPGs.
P334 Challenges And Advantages Adapting Recommendations: Gpc Breast Cancer
Authors: Peña Torres E , Alba M , Sierra F 
Published: August 2013

BackgroundDevelopment of a high-quality Clinical Practice Guideline (CPG) involves spending a significant amount of resources. Frequently, similar strategies are used around the world to achieve similar results. A method to utilise resources in a more efficient manner and to avoid the unnecessary duplication of efforts is to adapt existing guidelines. However, the methodological diversity of CPGs, specific regional conditions, and difficulties in the implementation of recommendations, impose a systematic approach for its adaptation that constitute an important methodological challenge, that must take into account the similarities between ade novodevelopment and an adaptation of guidelines. The process of adaptation requires systematic and transparent activities that disclose the considerations made to adjust the recommendations to a specific context.MethodsThe development of the GPC for breast cancer follows the steps proposed in the Methodological Guideline for the development of GPCs in the Colombian Health System.ResultsThe systematic search retributed 176 GPCs, 48 (27%) of which were qualified with the DELBI instrument as “highly recommended”. The Guideline Development Group (GDG) elaborated 41 questions, 30 (73%) were adapted following the methodology proposed by the ADAPTE collaboration. The remaining 11 (27%) developedde novo; 12,000 titles and publication summaries have been reviewed, of which 130 have been included and qualified with the system proposed for GRADE Working Group. The results take into account the challenges implied in the CPG adaptation processes.
P343 Selling Old Wine In New Bottles: Why It Is Worthwhile To Have Another Guideline Development Handbook?
Authors: Muche-Borowski C , Nothacker M , Kopp I 
Published: August 2013

BackgroundSince 1995, the Association of the Scientific Medical Societies in Germany (AWMF) maintains an open access, quality assured guideline register (www.awmf.org), currently containing 676 guidelines developed by 168 societies. While the societies are responsible for topic selection, development and content, the mission of AWMF is to promote, support and coordinate guideline development and to ensure the overall quality of the guideline register. To achieve this goal, AWMF established a new set of recommendations and rules.ContextPublished manuals for guideline developers do not fully meet the requirements of our national guideline system. Our manual takes into account the - development of methodological strategies - international consensus on key criteria for “good guidelines” - target group including guideline novices and clinical experts wishing to be informed about methodological developments but to delegate project management and basic methodological work - informational need to include guidelines into the AWMF register - specific requirements of the German health care system (e.g. the patients’ rights act)Description of Best PracticeOur manual consists of two parts. The first part includes recommendations and practical advice for guideline developers. The second part includes rules AWMF applies to judge inclusion into the register (e.g. addressing the management of conflict of interests).Lessons for Guideline Developers, Adaptors, Implementers, and/or UsersOur guideline development handbook which will be updated continuously may serve as an example for methodological guidance that is based on a systematic review of the international literature as well as the identification of national requirements and experience.
191WS Software Tools and Action Statement Profiles to Facilitate Guideline Development
Authors: Shiffman R , Rosenfeld R 
Published: August 2013

BackgroundDespite the importance of guideline recommendations being “actionable”, many current guidelines fail to meet standards for clarity, transparency, and implementability. These deficiencies contribute to failure of guidelines to influence care.Objectives/GoalsAttendees will • Learn how BRIDGE-Wiz software can lead developers to devise clear and actionable statements linked to appropriate indicators of evidence quality and recommendation strength; • Learn how eGLIA software can help to identify obstacles to successful implementation. • Learn how key action statements and action statement profiles can be used to support transparency of the guideline development process and promote successful implementation.Target Group, Suggested AudienceGuideline developers, guideline implementersDescription of the Workshop and of the Methods used to Facilitate InteractionsFollowing a brief overview of IOM standards for trustworthy guidelines and common problems in creating actionable recommendations, the facilitators will lead the “panel” through dynamic creation of a guideline recommendation using BRIDGE-Wiz. Attendees will function as a guideline development group responding to prompts from the software and interacting with the facilitators and one another. Facilitators will next provide a brief demonstration of eGLIA software appraising selected recommendations to identify implementability challenges. With audience participation, recommendations will be appraised and conflicting appraisals reconciled to create an implementability report. Finally, the construction and use of action statement profiles will be discussed. Action statement profiles summarise information about each recommendation and make explicit and transparent the process by which evidence and opinion are transformed into recommendations about appropriate care.
258WS Evidence to recommendations frameworks: Diagnosis
Authors: Schünemann H , Alonso P , Bossuyt P , Brozek J , Leeflang M , Deurenberg-Gopalakrishna G , Langendam M , Koster M , Mustafa R , Santesso N 
Published: August 2013

BackgroundMoving from evidence to recommendations (EtR) in guideline development requires balancing evidence quality with the benefits and harms of interventions, patient preferences, and resource and cost considerations. Developing recommendation about diagnostic tests and strategies is particularly challenging and requires tackling complex challenges, different than those needed for therapeutic interventions. The GRADE Working Group, has developed an approach to integrate these factors into development of clinical practice recommendations that is currently further defined in the DECIDE (Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence) project. This workshop will introduce this approach and evaluate the EtR framework based on examples and hands-on exercises.ObjectivesTo learn how to use and evaluate the EtR framework for diagnostic questions.Target Group, Suggested AudienceGuideline developers, systematic reviewers, clinicians.Description of the Workshop and of the Methods used to Facilitate InteractionsThis workshop provides a brief didactic overview of GRADE for diagnostic questions. Each group will use a systematic review and a partially pre-filled EtR framework. During the small group work, participants will discuss challenges and advantages of the approach. Participants will then apply these concepts in small groups to develop a recommendation based on the workshop material; there will be a plenary to provide feedback that will help to enhance the work and provide opportunities for collaboration.
002 Public Attitudes to and Knowledge of Healthcare Guidelines, and Methods to Communicate Guideline Recommendations to Patients and the Public – A Systematic Review
Authors: Loudon K , Santesso N , Callahan M , Harbour R , Thornton J , McFarlane E , Treweek S 
Published: August 2013

BackgroundImproving patient versions of guidelines is one way to support an increasing role for patients in health decision making.ObjectivesTo evaluate evidence on the public’s attitudes and knowledge of clinical practice guidelines AND what strategies have been used to communicate guideline recommendations to this group.MethodsWe conducted a systematic review of public attitudes and knowledge of clinical practice guidelines to inform the development of dissemination strategies for this population. We searched health databases from 2000 to 01/2013, grey literature, and we contacted guideline producers. Two reviewers independently abstracted, coded, synthesised themes from the studies.ResultsWe included 25 published studies and three reports (CCPG, NICE, SIGN). There was a huge variation in the public’s awareness of guidelines (12 studies) from 25–75%. The key themes to communicate guidelines (15 studies) to the public included, predictive factors (amount of education), personalisation, access to care, trustworthiness (evidence behind recommendations), and self-management.DiscussionAlthough there were few studies for thematic analysis there were recurrent themes. When developing patient versions, the danger could be to focus on detailed formatting instead of fundamental issues around whether patients dismiss guidelines as not applicable to their unique situation and restricts care. The results will inform work focused on the public and patients being done in EU FP7 DECIDE project.ImplicationsGuideline producers will need to increase the public’s awareness of clinical guidelines and developing communication strategies that are clearly personally applicable, trustworthy and useful for patients and carers managing their care.