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Living systematic reviews: 4. Living guideline recommendations

2017; Elsevier BV; Volume: 91; Linguagem: Inglês

10.1016/j.jclinepi.2017.08.009

1878-5921

Elie A. Akl, Joerg J Meerpohl, Julian Elliott, Lara A Kahale, Holger J. Schünemann, Thomas Agoritsas, John Hilton, Caroline Perron, Elie A. Akl, Rebecca K Hodder, Charlotte Pestridge, Lauren Albrecht, Tanya Horsley, Joanne Platt, Rebecca Armstrong, Phi Hùng Nguyễn, Robert M. Plovnick, Anneliese Arno, Noah Ivers, Gail Quinn, Agnes Au, Renea V Johnston, Gabriel Rada, Matthew K. Bagg, Arwel W. Jones, Philippe Ravaud, Catherine Boden, Lara A Kahale, Bernt Richter, Isabelle Boisvert, Homa Keshavarz, Rebecca Ryan, Linn Brandt, Stephanie A. Kolakowsky‐Hayner, Dina H. Salama, Alexandra Bražinová, Sumanth Kumbargere Nagraj, Georgia Salanti, Rachelle Buchbinder, Toby J Lasserson, Lina Santaguida, Chris Champion, Rebecca Lawrence, Nancy Santesso, Jackie Chandler, Zbigniew Leś, Holger J. Schünemann, Andreas Charidimou, Stefan Leucht, Ian Shemilt, Roger Chou, Nicola Low, Diana Sherifali, Rachel Churchill, Andrew I.R. Maas, Reed Siemieniuk, Maryse C. Cnossen, Harriet MacLehose, Mark Simmonds, Marie-Joëlle Cossi, Malcolm Macleod, Nicole Skoetz, Michel Jacques Counotte, Iain Marshall, Karla Soares‐Weiser, Samantha Craigie, Iain Marshall, Velandai Srikanth, Philipp Dahm, Nicole Martin, Katrina Sullivan, Alanna Danilkewich, Laura Martínez García, Anneliese Synnot, Kristen Danko, Chris Mavergames, Mark Taylor, Emma Donoghue, Lara Maxwell, Kris Thayer, Corinna Dressler, James H. McAuley, James Thomas, Cathy Egan, Steve McDonald, Roger Tritton, Julian Elliott, Joanne E. McKenzie, Guy Tsafnat, Sarah A. Elliott, Joerg J Meerpohl, Peter Tugwell, Itziar Etxeandia‐Ikobaltzeta, Bronwen Merner, Alexis F. Turgeon, Robin Featherstone, Stefania Mondello, Tari Turner, Ruth Foxlee, Richard Morley, Gert van Valkenhoef, Paul Garner, Marcus R. Munafò, Per Olav Vandvik, Martha Gerrity, Zachary Munn, Byron Wallace, Paul Glasziou, Melissa Murano, S Wallace, Sally Green, Kristine Newman, Chris Watts, Jeremy Grimshaw, Robby Nieuwlaat, Laura Weeks, Kurinchi Selvan Gurusamy, Adriani Nikolakopoulou, Aaron Weigl, Neal Haddaway, Anna H Noel-Storr, George Wells, Lisa Hartling, Annette M. O’Connor, Wojtek Wiercioch, Jill A. Hayden, Matthew J. Page, Luke Wolfenden, Mark Helfand, Manisha Pahwa, Juan José Yepes‐Nuñez, Julian P. T. Higgins, Jordi Pardo Pardo, Jennifer Yost, Sophie Hill, Leslea Pearson,

Delphi Technique in Research

While it is important for the evidence supporting practice guidelines to be current, that is often not the case. The advent of living systematic reviews has made the concept of "living guidelines" realistic, with the promise to provide timely, up-to-date and high-quality guidance to target users. We define living guidelines as an optimization of the guideline development process to allow updating individual recommendations as soon as new relevant evidence becomes available. A major implication of that definition is that the unit of update is the individual recommendation and not the whole guideline. We then discuss when living guidelines are appropriate, the workflows required to support them, the collaboration between living systematic reviews and living guideline teams, the thresholds for changing recommendations, and potential approaches to publication and dissemination. The success and sustainability of the concept of living guideline will depend on those of its major pillar, the living systematic review. We conclude that guideline developers should both experiment with and research the process of living guidelines.