WP1 Justification

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WP1 Justification Guideline Development
Keith Horner
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Work package 1 objectives
1. to perform a systematic review of CBCT based
on dose and risk, diagnostic accuracy and
quality assurance
2. to develop provisional guidelines to input
into WP6.
3. to incorporate knowledge obtained from the
results of SEDENTEXCT study
4. to develop definitive referral criteria and
guidelines on quality assurance, optimization
etc. to input into WP6.
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Objectives for Year 2
Due Date Status
D1.1 (M1.4) Systematic review complete 31 Jan 2009 Completed
M1.5 Second Guideline Development Panel (GDP) meeting 31 Mar 2009 Completed 12/13 March 2009
D1.2 Provisional guidelines developed 31 Mar 2009 Completed 6 April 2009
Deferred deadlines agreed with EC through
Annual Report process
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Scientific Progress Report
Systematic Review process
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Scientific Progress Report
Systematic Review process
Critical appraisal using standard forms
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Scientific Progress Report
Guideline development process evidence tables
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Scientific Progress Report

• Panel meeting (March 2009)
• Each topic addressed by two assessors
• Asked to consider evidence tables and formulate
  recommendations, taking into account
• Volume of evidence
• Applicability of the findings to clinical
  practice
• Generalisibility of the results presented to the
  guidelines target population
• Consistency of the results (highlighting any
  major inconsistencies)
• Clinical impact (e.g resource implications,
  balance of risk/benefit)

Guideline development
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Scientific Progress Report
Provisional Guideline document

• Internal/ external review pre-release (v1.0)
• Feedback after release of v1.1
• Dissemination

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Scientific Progress Report
Systematic Review process problems encountered

• Some allocation of studies into wrong categories
• Some papers for review fitted several categories,
  not just one.
• The review form design for diagnostic accuracy
  studies could have been better

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Forward Planning
Start earlier
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Forward Planning
Finalise the revised proformas for systematic
review and data extraction (UNIMAN/MAHOD)
Set up intranet pages for posting of papers for
review (UNIMAN)
Analyse feedback on Provisional Guidelines
document (UNIMAN)
Continue with literature searches and collection
of national guideline documentation (UNIMAN)
Confirmation of membership of Guideline
Development Panel (all partners except LTO)
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Diagnostic accuracy or Studies of diagnostic
relevance
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Protocol 1
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Protocol 1
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Protocol 2
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Protocol 2
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Protocol 2
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Forward Planning