International Guideline Development

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International Guideline Development

• Background and Goals of the International
  Guideline Network
• 28 April 2003

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What are CPGs ?

• ...systematically developed statements
• to assist important professional and patient
• decisions about appropriate health care
• for specific clinical circumstances.
• Institute of Medicine
• Clinical Practice Guidelines Directions for a
  New Program. (1990)
• Guidelines for Clinical Practice From
  Development to Use. (1992)
• Setting Priorities for Clinical Practice
  Guidelines. (1995)
• Washington DC National Academy Press, 1995.

Council of Europe Rec. No. R (01) 13
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Why do we need Guidelines ? To transfer
evidence into recommendations on best medical
practice as a basis of quality promotion
J. Slutsky, US Guideline Clearinghouse, 2002
www.cpg2002.de
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Factors for Success of CPGs

• The success and failure
• of clinical practice guidelines depend on
• their quality and medical value,
• social, legal and ethical aspects involved,
• their implementation in daily practice.

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Problems of Guidelines WorldwideQuality Deficits

• 1. Missing links between recommendations and
  evidences
• 2. Few information on development process,
  sponsorship, implementation tools
• 3. Cost-benefit-questions often excluded as
  topics
• 4. Conflicting guidelines on relevant topics
• 5. More academic recommandations than help for
  every day practice

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International CPG Quality Activities
Promotion of intern. networking between
organisations, research institutions,
clearinghouses and other agencies producing
evidence-based medical information.

• Agree Collaboration
• (Biomed 2, EU)
• Council of Europe CPG Recommend.
• G-I-N

• Research, training on high quality CPG devel. /
  use
• Policy paper on CPG standards
• CPG information, dissemination, networking

Council of Europe Rec. No. R (01) 13
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G-I-N Background
In 2001 the Council of Europe recommended to
promote networking of CPG organisations. In
Summer 2002 a working group representing 11
organisations from 8 countries developed the
framework for an internat. Guidelines Network.
In November 2002 a Founding Committee consented
on a constitution for the Guidelines
International Network and established an
executive board. Until 28th April 2003 a total of
42 organisations from 23 countries became of
G-I-N Members.
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Mission Statement
G.I.N. seeks to improve the quality of health
care by promoting systematic development of
clinical practice guidelines and their
application into practice, through supporting
international collaboration.
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J.Briggs Inst.for Evid.Based NursingMidwifery,
AUS National Institute of Clinical Studies NICS,
AUS Austrian Ass.for Quality in Healthcare,
A Belgian Center for Evidence based Medicine,
B Flemish College of General Practitioners,
B Program in Evidence-based Care, Cancer Care
Ontario, CDN Danish Guidelines Secretariat,
DK Finnish Medical Society Duodecim, FIN Finnish
Office for HTA FINOHTA, FIN French Nat.Agency for
Accred., Eval in Healthcare ANAES, F French
National Federation of Cancer Research Centres,
F German Association of Scientific Medical
Societies AWMF, D Berlin Chamber of Physicians,
D German Agency for Quality in Medicine ÄZQ,
D Royal College of Surgeons in Ireland RCSI, IRL
Iceland Directorate of Health, ISL Italian
Evidence-Based Medicine Group GIMBE, I Regional
Health Agency Emilia-Romagna, I Malaysian
Ministry of Health, MAL New Zealand Accident
Compensation Corporation, NZ New Zealand
Guidelines Group, NZ Norwegian Directorate for
Health and Social Affairs, NO Polish Institute
for EbM, PL Polish Soc.for Quality Promotion in
Healthcare, PL Portuguese Institute for Quality
in Healthcare, POR Slovene Guidelines Group,
SLO Basque HTA Office OSTEBA, E Josep Laporte
Library Foundation, Barcelona, E Swedish Board of
Health and Welfare (Socialstyrelsen), S Clinical
Epidemiology Center Lausanne , CH Swiss Medical
Association FMH, CH Dutch Association of
Comprehensive Cancer Centres, NL  Dutch College
of General Practitioners, NL Dutch Institute for
Healthcare Improvement CBO, NL National Institute
for Clinical Excellence NICE, UK Centre for
Reviews Dissemination York, UK Scottish
Intercollegiate Guidelines Network, UK Sowerby
Centre for Health Informatics at Newcastle,
UK Agency for Health Research Quality AHRQ, USA
National Kidney Foundation, USA AGREE
Collaboration, INT World Health Organisation
Geneva WHO, INT

Membership April 2003

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G-I-N Goals

• Information sharing, knowledge transfer,
  collaborative working
• Improvement, harmonisation of methodologies for
  CPG development, dissemination, implementation,
  evaluation
• Support of research
• Coordination with other health care quality
  initiatives

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Benefits of G-I-N Membership

• Reduced costs and time of CPG development.
• Early, fast and easy access to new methodologies
  for CPG development, implementation and
  evaluation.
• Early and fast information about work programmes
  and plans of member organisations.

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G-I-Ns Future Activities

• Library of CPG development tools, templates and
  training materials.
• Register of completed / ongoing / planned
  research into guidelines.
• Harmonisation of electronic CPG formats.
• Integrating HTA and CPG.
• Involving patients / public in CPG work.
• Improving co-ordination of guideline development,
  implementation and evaluation.

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G-I-N Activities 2003

• Collating details of CPG published / in
  development / planned.
• Compiling / sharing / exchanging CPG background
  documentation (e.g. literature search strategies
  and evidence tables).
• Workshops / Conferences on CPGs

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International Symposium on Clinical Practice
Guidelines

• Networking for Evidence-Based Healthcare

November 14-16 2003 Edinburgh, Scotland