Guideline Development Support

What are Clinical Practice Guidelines?

Guidelines mean different things to different people. The National Academy of Medicine (NAM) defines clinical practice guidelines as “statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.”

What Purpose do Guidelines Serve?

Guidelines are used to:

• Inform clinical decision-making (clinicians)
• Guide coverage and policy decisions (policymakers)
• Assist in making personal care decisions (patients and caregivers)
• Help identify future research needs (researchers)

Who Develops Guidelines?

Guidelines are developed by a wide variety of national and international groups, including medical specialty societies, academic medical centers, healthcare organizations, health systems, and government agencies.

How Do I Differentiate Between Guidelines?

It can be difficult to determine, given the number of guidelines on various medical topics, which ones are the best fit for your specific needs. It is important to look for guidelines developed using rigorous and transparent methods. The 2011 NAM landmark report Clinical Practice Guidelines We Can Trust identified standards for developing trustworthy guidelines. These remain the gold standard in guideline development and include the following:

• Composition of Guideline Development Group
• Systematic Review of Evidence
• Foundations for Recommendations
• Funding Source Disclosure
• Disclosure and Management of Financial COIs
• External Review
• Updating

How Can I Develop Guidelines that Adhere to these Standards?

ECRI has more than 25 years of experience in supporting guideline development, guideline appraisal, and guideline dissemination. We have developed hundreds of systematic reviews underpinning clinical practice guidelines and have appraised and disseminated thousands of guidelines to a global audience. Furthermore, we have cultivated longstanding relationships with hundreds of guideline developers, many of whom have relied on our expertise in making their guidelines more methodologically robust and their processes more systematic and rigorous. ECRI continues to be a thought leader in the guideline community and a champion of advancing safe and effective patient care.

How ECRI Can Help

If your organization is interested in developing new or updating existing guidelines, methodologists from the ECRI-Penn Medicine Evidence-based Practice Center (EPC) can lend support. Our experienced research team includes clinicians, PhD- and master’s-level methodologists, and analysts who have supported national and international societies and federal agencies in their guideline development. We can work with your organization to:

• Critically appraise the evidence used to underpin your guideline through a systematic review.

• Provide customized training and interactive educational workshops to members of your guideline development group and staff. We can offer instruction on all phases of the guideline development process, including:

  • scoping your guideline and framing PICOT questions,
  • assessing individual study quality (risk of bias),
  • rating the body of evidence and strength of clinical recommendations, and
  • crafting actionable and articulate recommendation statements.

Master’s-level guideline specialists from the ECRI Guidelines Trust (EGT), our centralized repository of current, evidence-based guidelines, appraise guidelines using the National Guideline Clearinghouse Extent Adherence to Trustworthy Standards (NEATS) instrument. Providing an appraisal score helps clinicians, educators, policymakers, payers, and patients gauge their confidence in a specific clinical practice guideline. We can help your organization with the following:

• Enhance your guideline development process with an unbiased assessment that offers strategies and recommendations for improvement and alignment with NAM standards for developing trustworthy guidelines.
• Manage your guideline panel members’ financial and intellectual conflicts of interest throughout the development process.
• Identify appropriate guideline recommendations for extraction and uptake into clinical decision support systems.

Master’s-level medical research librarians and bibliographic database management and information experts from the ECRI Information Center are key contributors on our guideline projects. We can also help as follows:

• Offer guidance to your staff and guideline panel members about documented, systematic, and comprehensive literature searches.
• Conduct literature searches on your behalf using multiple databases and information sources and providing documented search strategies and retrievals to ensure your search process is not only transparent but reproducible to accommodate guideline updates.

How ECRI is Unique

ECRI staff supporting your guideline efforts are unbiased and free from conflicts of interest. For more than 50 years, our strict conflict-of-interest (COI) policy has provided assurance about the integrity of our work. Our COI policy applies to our entire staff, extending beyond financial interest to include emotional and intellectual conflicts or bias.

Peer-Reviewed Publications

Journal articles derived from some of the guidelines ECRI supported in recent years include the following:

• 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases. Arthritis Care Res. PMID: 36597813. | Arthritis Rheumatol. PMID: 36597810.
• 2021 American College of Rheumatology Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Oligoarthritis, Temporomandibular Joint Arthritis, and Systemic Juvenile Idiopathic Arthritis. Arthritis Care Res. PMID: 35233986. | Arthritis Rheumatol. PMID: 35233993.
• Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. J Urol. PART I. PMID: 33309062. | PART II. PMID: 33309061.
• Medical Care of Adults with Down Syndrome: A Clinical Guideline. JAMA. PMID: 33079159.

Interested in learning more?

Setup a consultation with an ECRI expert to learn more about getting assistance to create new or updated guidelines.