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

2. 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.

3. 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.

4. Signal detection process

5. 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:
sent to all NAC member asking for experts in neurology and hematology to review recommendations
Responses from B.C., Alberta, Ontario, New Brunswick

6. Methodology

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

8. 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Feasby TE: Appropriateness of IVIG—hematology summaries (unpublished).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,
Question, PICO and search provided but incomplete
Chalmers Research Institute: IVIG systematic reviews.(unpublished).
Strategy provided by Margaret Sampson
Request for questions and PICOS

9. 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

10. Example of PICO framework for updated search