Evidence map›Paper›PMID 24383701›Full record

SynthesisImplementation science : IS2014

Guidance for updating clinical practice guidelines: a systematic review of methodological handbooks.

Robin W M Vernooij, Andrea Juliana Sanabria, Ivan Solà, Pablo Alonso-Coello, Laura Martínez García

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Implementation science : IS, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 24 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 24 syntheses or guidelines pooled it.

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  2. Clinical Practice Guidelines on Normal Labour and Childbirth: A Systematic Review.BJOG : an international journal of obstetrics and gynaecology · 2026
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  7. Gender bias in shared decision-making among cancer care guidelines: A systematic review.Health expectations : an international journal of public participation in health care and health policy · 2023
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  8. Testing guidelines during times of crisis: challenges and limitations of developing rapid and living guidelines.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2023
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33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Robin W M Vernooij
Andrea Juliana Sanabria
Ivan Solà
Pablo Alonso-CoelloIberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), C/ Sant Antoni Maria Claret 167, Barcelona 08025, Spain. palonso@santpau.cat.
Laura Martínez García

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUpdating clinical practice guidelines (CPGs) is a crucial process for maintaining the validity of recommendations. Methodological handbooks should provide guidance on both developing and updating CPGs. However, little is known about the updating guidance provided by these handbooks.

methodsWe conducted a systematic review to identify and describe the updating guidance provided by CPG methodological handbooks and included handbooks that provide updating guidance for CPGs. We searched in the Guidelines International Network library, US National Guidelines Clearinghouse and MEDLINE (PubMed) from 1966 to September 2013. Two authors independently selected the handbooks and extracted the data. We used descriptive statistics to analyze the extracted data and conducted a narrative synthesis.

resultsWe included 35 handbooks. Most handbooks (97.1%) focus mainly on developing CPGs, including variable degrees of information about updating. Guidance on identifying new evidence and the methodology of assessing the need for an update is described in 11 (31.4%) and eight handbooks (22.8%), respectively. The period of time between two updates is described in 25 handbooks (71.4%), two to three years being the most frequent (40.0%). The majority of handbooks do not provide guidance for the literature search, evidence selection, assessment, synthesis, and external review of the updating process.

conclusionsGuidance for updating CPGs is poorly described in methodological handbooks. This guidance should be more rigorous and explicit. This could lead to a more optimal updating process, and, ultimately to valid trustworthy guidelines.

Indexed as

Practice Guidelines as TopicEvidence-Based MedicineHumansInformation Dissemination

Identifiers

PMID24383701
PMCPMC3904688

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.