American College of Physicians, Philadelphia, Pennsylvania 19106, USA.
Ann Intern Med. 2012 Apr 3;156(7):525-31. doi: 10.7326/0003-4819-156-7-201204030-00009.
Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. Institute of Medicine and the United Kingdom's National Institute for Health and Clinical Excellence have developed recommendations to define trustworthy guidelines within their locales. Many groups charged with guideline development find the lengthy list of standards developed by such organizations to be aspirational but infeasible to follow in entirety. Founded in 2002, the Guidelines International Network (G-I-N) is a network of guideline developers that includes 93 organizations and 89 individual members representing 46 countries. The G-I-N board of trustees recognized the importance of guideline development processes that are both rigorous and feasible even for modestly funded groups to implement and initiated an effort toward consensus about minimum standards for high-quality guidelines. In contrast to other existing standards for guideline development at national or local levels, the key components proposed by G-I-N will represent the consensus of an international, multidisciplinary group of active guideline developers. This article presents G-I-N's proposed set of key components for guideline development. These key components address panel composition, decision-making process, conflicts of interest, guideline objective, development methods, evidence review, basis of recommendations, ratings of evidence and recommendations, guideline review, updating processes, and funding. It is hoped that this article promotes discussion and eventual agreement on a set of international standards for guideline development.
指南制定过程差异很大,许多指南不符合基本质量标准。指南制定标准可以帮助组织确保建议是基于证据的,并帮助用户识别高质量的指南。美国医学研究所和英国国家卫生与临床优化研究所等组织已经制定了在当地范围内定义可信指南的建议。许多负责指南制定的组织发现,这些组织制定的冗长的标准清单虽然令人向往,但完全遵循是不切实际的。成立于 2002 年的指南国际网络(G-I-N)是一个指南制定者网络,包括 93 个组织和 89 名代表 46 个国家的个人成员。G-I-N 理事会认识到,即使是资金有限的组织,实施严格且可行的指南制定过程也很重要,并为此努力就高质量指南的最低标准达成共识。与国家或地方一级其他现有的指南制定标准不同,G-I-N 提出的关键组成部分将代表活跃的国际、多学科指南制定者的共识。本文介绍了 G-I-N 为指南制定提出的一套关键组成部分。这些关键组成部分涉及小组组成、决策过程、利益冲突、指南目标、开发方法、证据审查、建议基础、证据和建议评级、指南审查、更新流程和资金。希望本文能促进关于一套国际指南制定标准的讨论,并最终达成一致。
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