IVIG guideline update Signal Detection Analysis Alan Tinmouth Oct 15th, 2015

Update Waiting for contract with University of Ottawa Evidence-based Practice Centre to be approved by new lead province Contract was send to from Manitoba to UofO EPC in September Contract under review by legal department Work begun in earnest in last 2 weeks.

Objective To assess the currency of the following two clinical practice guideline recommendations using the Ottawa Method’s qualitative signal detection approach:  Guideline on the use of Intravenous Immune Globulin (IVIG) for the following 22 Neurologic conditions. Guideline on the use of Intravenous Immune Globulin (IVIG) for the following 18 Hematologic conditions.

Signal detection process

Methodology Phase I: Locating disease specific recommendations (for or against) in the original guideline (IVIG use for hematologic 18 conditions; IVIG use for neurologic 22 conditions).  Completed (Expert opinion matrices) Developing a matrix to be sent to experts that will list the guideline recommendations. Contacting experts and seeking their opinion on whether new evidence suggests any of the followings for the intervention(s) of interest in the population stated in the specific recommendation In process: Email sent to all NAC member asking for experts in neurology and hematology to review recommendations Responses from B.C., Alberta, Ontario, New Brunswick

Methodology

Methodology Phase II Conducting an updated electronic search need for search strategy, Question and PICOs Screening the retrieved records need for Question, and PICOs

Methodology Research question & PICO (Hematology): Feasby TE: Appropriateness of IVIG—hematology summaries (unpublished). Not available Biotext Science Information Consultants: A systematic literature review and report on the efficacy of intravenous immunoglobulin therapy and its risks. Final Report v04. Australian National Blood Authority, 2004. www.nba.gov.au/pubs.htm Question, PICO and search provided but incomplete Chalmers Research Institute: IVIG systematic reviews.(unpublished). Strategy provided by Margaret Sampson Request for questions and PICOS

Methodology Research question & PICO (Neurology): Systematic reviews by the Chalmers Research Institute, University of Ottawa Strategy provided by Margaret Sampson Request for questions and PICOS The Appropriateness of IVIG evidence review conducted by Feasby as part of Canadian Institute for Health Research– funded research, University of Alberta Not available

Example of PICO framework for updated search