Department of Health Research Methods, Evidence, and Impact (Wiercioch, Akl, Santesso, Zhang, Morgan, Baldeh, Mustafa, Etxeandia-Ikobaltzeta, Carrasco-Labra, Ventresca, Brignardello-Petersen, Morgano, Brożek, Schünemann), McMaster University, Hamilton, Ont.; Department of Internal Medicine (Akl), American University of Beirut, Beirut, Lebanon; School of Medicine (Yepes-Nuñez), Universidad de los Andes, Bogotá, Colombia; Department of Internal Medicine (Kowalski), Federal University of Paraná, Curitiba, Brazil; Division of Nephrology and Hypertension (Mustafa), Department of Medicine, University of Kansas Medical Center, Kansas City, Kan.; Guideline Development Group (Laisaar), Faculty of Medicine, Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Ministry of Social Affairs (Raid), Tallinn, Estonia; Department of Internal Medicine (Neumann), Pontificia Universidad Católica de Chile, Santiago, Chile; Federal University of Rio Grande do Sul (Falavigna), Institute for Health Technology Assessment, Porto Alegre, Brazil; Department of Medicine (Brożek, Schünemann), McMaster University, Hamilton, Ont.; Department of Innovation in Medical Education (McConnell), University of Ottawa, Ottawa, Ont.
CMAJ. 2020 Oct 5;192(40):E1138-E1145. doi: 10.1503/cmaj.200193.
Guideline recommendations may be affected by flaws in the process, inappropriate panel member selection or conduct, conflicts of interest and other factors. To our knowledge, no validated tool exists to evaluate guideline development from the perspective of those directly involved in the process. Our objective was to develop and validate a universal tool, the PANELVIEW instrument, to assess guideline processes, methods and outcomes from the perspective of the participating guideline panellists and group members.
We performed a systematic literature search and surveys of guideline groups (identified through contacting international organizations and convenience sampling of working panels) to inform item generation. Subsequent groups of guideline methodologists and panellists reviewed items for face validity and missing items. We used surveys, interviews and expert review for item reduction and phrasing. For reliability assessment and feedback, we tested the PANELVIEW tool in 8 international guideline groups.
We surveyed 62 members from 13 guideline panels, contacted 19 organizations and reviewed 20 source documents to generate items. Fifty-three additional key informants provided feedback about phrasing of the items and response options. We reduced the number of items from 95 to 34 across domains that included administration, training, conflict of interest, group dynamics, chairing, evidence synthesis, formulating recommendations and publication. The tool takes about 10 minutes to complete and showed acceptable measurement properties.
The PANELVIEW instrument fills a gap by enabling guideline organizations to involve clinicians, patients and other participants in evaluating their guideline processes. The tool can inform quality improvement of existing or new guideline programs, focusing on insight into and transparency of the guideline development process, methods and outcomes.
指南建议可能受到流程缺陷、不当的专家组成员选择或行为、利益冲突等因素的影响。据我们所知,目前尚无经过验证的工具可用于从参与流程的人员的角度评估指南的制定。我们的目标是开发和验证一种通用工具,即 PANELVIEW 工具,以从参与指南的专家组成员和小组成员的角度评估指南的流程、方法和结果。
我们进行了系统的文献检索,并对指南小组(通过联系国际组织和方便抽样的工作组来确定)进行了调查,以获取项目生成的信息。随后,指南方法学家和专家组成员小组对项目的表面有效性和遗漏项目进行了审查。我们使用调查、访谈和专家审查来减少和调整项目措辞。为了进行可靠性评估和反馈,我们在 8 个国际指南小组中测试了 PANELVIEW 工具。
我们调查了来自 13 个指南小组的 62 名成员,联系了 19 个组织,并审查了 20 份原始文件以生成项目。另外 53 名关键知情人就项目措辞和回答选项提供了反馈。我们将项目数量从 95 项减少到 34 项,涵盖了管理、培训、利益冲突、小组动态、主持、证据综合、制定建议和发表等领域。该工具大约需要 10 分钟完成,并且表现出可接受的测量特性。
PANELVIEW 工具填补了空白,使指南组织能够让临床医生、患者和其他参与者参与评估其指南流程。该工具可以为现有或新的指南项目的质量改进提供信息,重点是深入了解和透明化指南的制定过程、方法和结果。