Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.
Clinical Research Institute (CRI), American University of Beirut Medical Center, Beirut, Lebanon.
BMC Health Serv Res. 2019 Oct 15;19(1):692. doi: 10.1186/s12913-019-4567-2.
Given the considerable efforts and resources required to develop practice guidelines, developers need to prioritize what topics and questions to address. This study aims to identify and describe prioritization approaches in the development of clinical, public health, or health systems guidelines.
We searched Medline and CINAHL electronic databases in addition to Google Scholar. We included papers describing prioritization approaches in sufficient detail allowing for reproducibility. We synthesized findings in a semi-quantitative way. We followed an iterative process to develop a common framework of prioritization criteria that captures all of the criteria reported by each included study.
Our search captured 33,339 unique citations out of which we identified 10 papers reporting prioritization approaches for guideline development. All of the identified approaches focused on prioritizing guideline topics but none on prioritizing recommendation questions or outcomes. The two most frequently reported steps of the development process for these approaches were reviewing the grey literature (9 out of 10, 90%) and engaging various stakeholders (9 out of 10, 90%). We derived a common framework of 20 prioritization criteria that can be used when prioritizing guideline topics. The most frequently reported criteria were the health burden of disease which was included in all of the approaches, practice variation (8 out of 10, 80%), and impact on health outcomes (7 out of 10, 70%). Two of the identified approaches stood out as being comprehensive and detailed.
We described 10 prioritization approaches in the development of health practice guidelines. There is a need to assess the effectiveness, efficiency and transparency of the identified approaches and to develop standardized and validated priority setting tools.
鉴于开发实践指南需要付出相当大的努力和资源，开发者需要优先考虑要解决哪些主题和问题。本研究旨在确定和描述临床、公共卫生或卫生系统指南制定中的优先排序方法。
我们搜索了 Medline 和 CINAHL 电子数据库以及 Google Scholar。我们纳入了详细描述优先排序方法的论文，以便于重现。我们以半定量的方式综合研究结果。我们采用迭代过程制定了一个通用的优先排序标准框架，该框架涵盖了每项纳入研究报告的所有标准。
我们的搜索捕获了 33339 个独特的引文，从中我们确定了 10 篇报告指南制定优先排序方法的论文。所有确定的方法都集中在优先排序指南主题上，但没有优先排序推荐问题或结果。这些方法开发过程中报告最多的两个步骤是审查灰色文献（10 篇中的 9 篇，90%）和让各种利益相关者参与（10 篇中的 9 篇，90%）。我们得出了一个通用的 20 项优先排序标准框架，可用于优先排序指南主题。报告最多的标准是疾病的健康负担，所有方法都包括该标准，其次是实践差异（10 篇中的 8 篇，80%）和对健康结果的影响（10 篇中的 7 篇，70%）。其中两种方法被认为是全面和详细的。
我们描述了 10 种在制定健康实践指南中的优先排序方法。需要评估所确定方法的有效性、效率和透明度，并开发标准化和经过验证的优先级设置工具。
