KDIGO Guidelines Development: Strengths and Challenges KDIGO Controversies Conference Clinical Practice Guidelines: Methodology October 12, 2007 Joseph.

Slides:

Advertisements

Similar presentations

Evidence-based Dental Practice Developing guidelines or clinical recommendations Slide #1 This lecture follows the previous online lecture on evidence.

Advertisements

Participation Requirements for a Guideline Panel Member.

Tufts-New England Medical Center Evidence-based Practice Center Boston, MA Joseph Lau, MD, Director Ethan Balk, MD, MPH, Associate Director Thomas Trikalinos,

Participation Requirements for a Guideline Panel Co-Chair.

Globalize the Evidence, Localize the Decision A Kaiser Permanente and BMJ Evidence Centre Collaborative Case Study Klara Brunnhuber Carrie Davino-Ramaya.

Using Available Systemic Reviews to Inform Guidelines Development KDIGO Controversies Conference Clinical Practice Guidelines: Methodology October 12,

Life-cycle model ccWGs 22 May 2014 Bart Boswinkel ccNSO Senior Policy Advisor.

Participation Requirements for a Patient Representative.

American College of Chest Physicians (ACCP) Health and Science Policy Committee Orientation Program Part #1 General Overview and Structure.

April 2009 Netta Conyers-Haynes, Principal Consultant, Communications Kaiser Permanente National Guideline Program Implications of IOM SR Standards Wiley.

The Community Engagement Studio: Strengthening Research Capacity through Community Engagement Consuelo H. Wilkins, MD, MSCI Executive Director, Meharry.

Mary Barton, MD, MPP Vice President, Performance Measures “Balancing scientific and social dimensions of guidelines”

James Tattersall European Best Practice Guidelines.

Participation Requirements for a Guideline Panel PGIN Representative.

1 Implementing GRADE Experience of the Tufts Center for Kidney Disease Guideline Development and Implementation Tufts Medical Center, Boston MA Guideline.

1 The U.S. Preventive Services Task Force: The Challenge of Transparency Dr. Albert Siu New York Academy of Medicine.

PATIENT-CENTERED OUTCOMES RESEARCH INSTITUTE PCORI Board of Governors Meeting Washington, DC September 24, 2012 Sue Sheridan, Acting Director, Patient.

April 2009 Netta Conyers-Haynes, Principal Consultant, Communications Kaiser Permanente National Guideline Program (NGP): Implications of IOM CPG Standards.

Publishing qualitative studies H Maisonneuve April 2015 Edinburgh, Scotland.

Implementation Survey Results – Systematic Review Questions Next Steps: Implementation Workshop on Standards for Systematic Reviews and Clinical Practice.

McLean Promotion to Associate Professor at Harvard Medical School Maureen T. Connelly, MD, MPH McLean Hospital February 3, 2010.

American Psychiatric Association Practice Guideline Development Challenges and Ideas for Standards.

Systematic Reviews and the American Academy of Pediatrics Virginia A. Moyer, MD, MPH Professor of Pediatrics Baylor College of Medicine.

NCCN and NCCN Clinical Practice Guidelines in Oncology™

The American Society of Transplantation (AST) Guideline Development Process.

Strengths and challenges of the CPG development process: Canadian Society of Nephrology Marcello Tonelli MD SM Chair, CSN-CPG Committee.

Topic Generation and Research Prioritization Joe V. Selby, MD, MPH, Executive Director Rachael Fleurence, PhD, Scientist Rick Kuntz, MD, MSc, Chair, PDC.

From Evidence to EMS Practice: Building the National Model Eddy Lang, MD, CFPC (EM), CSPQ SMBD-Jewish General Hospital, McGill University Montreal, Canada.

Critical Appraisal of Clinical Practice Guidelines

Time Tested Guideline Development and Implementation : The Institute for Clinical Systems Improvement (ICSI) Collaborative Process © 2007 Institute for.

Development of Clinical Practice Guidelines for the NHS Dr Jacqueline Dutchak, Director National Collaborating Centre for Acute Care 16 January 2004.

Minnesota Public Health Collaborative for Quality Improvement Health Improvement Planning: Community Engagement September, 2009.

U.S. Department of Agriculture Center for Nutrition Policy and Promotion Slides provided by the USDA Center for Nutrition Policy and Promotion.

Brief summary of the GRADE framework Holger Schünemann, MD, PhD Chair and Professor, Department of Clinical Epidemiology & Biostatistics Professor of Medicine.

A Comparison of 42 Local, National, and International HIA Guidelines Andrew L. Dannenberg, MD, MPH Katherine Hebert, MCRP Arthur M. Wendel, MD, MPH Sarah.

The ACC/AHA Perspective Alice K. Jacobs, MD, FAHA, FACC Professor of Medicine Boston University Medical Center Chair, ACC/AHA Task Force on Practice Guidelines.

IAOD Evaluation Section, the Development Agenda (DA) and Development Oriented Activities Julia Flores Marfetan, Senior Evaluator.

ESMO Clinical Practice Guidelines: Consensus Conference (CC) SOP Edited by EDC-SC September 2013.

Organization and guideline development April 2010 ACCC The Netherlands.

Implementing GRADE in Guideline Development: Real-World Experiences NIAID Guidelines for the Diagnosis and Management of Food Allergy Dr. Matthew Fenton.

TEACH LEVEL II: CLINICAL POLICIES AND GUIDELINES STREAM Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center.

Host Country Committee Work Program for the period Discussion during HCC Meeting, February 15/ Washington, D.C. Juan Pedro Searle Solar.

Clinical Practice Guidelines By Dr. Hanan Said Ali.

Formulation of a Strategy: A Framework for Action IOM Workshop on Standards for Systematic Reviews and Clinical Practice Guidelines May 10-11, 2011 University.

Systematic Reviews and American College of Physicians Clinical Practice Guidelines Amir Qaseem, MD, PhD, MHA, FACP Director, Clinical Policy American College.

Strategy for the assessment of information on DDT John Githure.

TDRp Implementation Challenges David Vance, Executive Director Peggy Parskey, Assistant Director October 23, 2014.

Guidelines Recommandations. Role Ideal mediator for bridging between research findings and actual clinical practice Ideal tool for professionals, managers,

Evidence-Based Practice

EVIDENCE BASED PRACTICE CENTER Melissa McPheeters, PhD Co-Director, Vanderbilt EPC Engaging Stakeholders in EPC Work.

1 Project Coordinators’ meeting March 2010 NATIONAL TEMPUS OFFICES (NTOs) & HIGHER EDUCATION REFORMS.

IOWA Department of Education A Continuing Conversation Assessment in Iowa: Where are we now? Where are we going? November 1, 2013.

Advisory Forum, September 2005 Producing guidelines Johan Giesecke.

H ⊕ lger Schünemann, MD, PhD Professor and Chair, Dept. of Clinical Epidemiology & Biostatistics Professor of Medicine Michael Gent Chair in Healthcare.

Institute of Medicine Committee on Standards for Developing Trustworthy Clinical Practice Guidelines Washington, DC January 11, 2010 Marguerite Koster,

A Framework for Assessing Needs Across Multiple States, Stakeholders, and Topic Areas Stephanie Wilkerson & Mary Styers REL Appalachia American Evaluation.

Workshop on Standards for Clinical Practice Guidelines Institute of Medicine January 11, 2010 Vivian H. Coates, Vice President, ECRI Project Director,

Making Clinical Practice Guidelines “Better” Katrin Uhlig, MD MS Director, Guideline Development Tufts Center for Kidney Disease Guideline Development.

Standards for Developing Trustworthy Clinical Practice Guidelines Standards for Developing Trustworthy Clinical Practice Guidelines Institute of Medicine.

Developing a guideline

MUHC Innovation Model.

Guidelines International Network

Guideline Development

Systematic Review, Synthesis, & Clinical Practice Guidelines

WHO Guideline development

Support for the AASHTO Committee on Planning (COP) and its Subcommittees in Responding to the AASHTO Strategic Plan Prepared for NCHRP 8-36, TASK 138.

Volume 146, Issue 1, Pages (July 2014)

GUIDELINE COLLABORATION Clinical Practice Guidelines, Development and Implementation in Mexico: International Forum Sandra Zelman Lewis, PhD November.

From the Evidence Analysis to the Creation of Evidence Based Guidelines 1.

What Should a Guideline Panel Do When Evidence Is Inconclusive

Presentation transcript:

KDIGO Guidelines Development: Strengths and Challenges KDIGO Controversies Conference Clinical Practice Guidelines: Methodology October 12, 2007 Joseph Lau, MD Tufts-New England Medical Center

Selection of guideline committee/workgroup members 12 – 15 workgroup members; 2 co-chairs Workgroup co-chairs identify potential workgroup members with input from KDIGO co-chairs Multidisciplinary workgroup members International representation

Evidence Review Team Tufts-New England Medical Center (Boston) Co-director (EBM) Joseph Lau Co-director (Nephrology) Katrin Uhlig Associate director (EBM) Ethan Balk NKF fellows (2) Research associate Research assistants Contributing international methodologists –Jonathan Craig (Australia) –John Ioannidis (Greece) –Jin Ling Tang (Hong Kong)

Selection and prioritization of guideline topics Before first workgroup meeting, workgroup co-chairs draft preliminary scope of work ERT conducts preliminary literature search A series of teleconferences of workgroup co- chairs with ERT to create draft key questions and review criteria Topics, key questions, and review criteria discussed and refined at workgroup meetings and teleconferences

Origin of KDIGO methods KDIGO uses proven KDOQI methodologies (evolving) KDOQI methodologies have been used since 2000, have resulted in 6 KDOQI guidelines and 3 updates Supported by the ERT at Tufts-NEMC

Abridged KDIGO guidelines development method Follows well-defined and rigorous methods Four 1.5 day meetings over 2 years Conflict of interest management Training of workgroup members in EB methods / CPG development (CME offered) Initial key questions formulation Literature review Summary and grading of evidence Drafting guidelines statements Grading of recommendations Advisory board feedback Public review

Dissemination and Implementation Published as Kidney International Supplement Guidelines are designed to be adopted by different countries according to local needs

Strengths and Challenges of KDIGO Strengths 1.Best experts in the field (know the issues, involved in research) 2.Multidisciplinary 3.International representation 4.Stable dedicated ERT (efficiency, reproducibility, institutional memory) 5.Rigorous methods, training of WG members and fellows 6.Explicit grading of evidence and recommendations 7.Well funded projects Challenges 1.Experts hold strong opinions, industry funding, perceived COI 2.Difficult to achieve a balanced representation of all relevant disciplines 3.Difficult to have people represent the world, communications across many time zones a challenge 4.Stable dedicated ERT (stale) 5.Resource intensive, takes a lot of time, foreign terminologies 6.Grading of evidence and recommendations an evolving field 7.Choice of guidelines topics dictated by funding source

Current KDIGO Topics Hepatitis C (in press) Mineral and Bone Disease (3/4 way) Kidney Transplantation (1/2 way)

Future Outlook Grading of evidence and recommendations is evolving Debate on allowable evidence for guidelines Novel attempt, we currently know very little about the feasibility or the success of translation or adoption of guidelines across different countries