Defining key questions for clinical practice guidelines: a novel approach for developing clinically relevant questions
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(2020) 18:113
RESEARCH
Open Access
Defining key questions for clinical practice guidelines: a novel approach for developing clinically relevant questions Samantha Chakraborty1* , Bianca Brijnath1,2, Jacinta Dermentzis1 and Danielle Mazza1
Abstract Background: There is no standardised protocol for developing clinically relevant guideline questions. We aimed to create such a protocol and to apply it to developing a new guideline. Methods: We reviewed international guideline manuals and, through consensus, combined steps for developing clinical questions to produce a best-practice protocol that incorporated qualitative research. The protocol was applied to develop clinical questions for a guideline for general practitioners. Results: A best-practice protocol incorporating qualitative research was created. Using the protocol, we developed 10 clinical questions that spanned diagnosis, management and follow-up. Conclusions: Guideline developers can apply this protocol to develop clinically relevant guideline questions. Keywords: Clinical judgement, Key clinical questions, Guideline scope, Clinical practice guideline, Implementation, General practitioner, GP, Guideline methodology, Guideline manual
Background Clinical guidelines have the potential to translate knowledge into practice through rigorous assessment of the medical literature and to help to establish norms of practice for a clinical topic [1]. General practitioners (GPs) experience challenges in diagnosing and managing mental health conditions that have arisen as a result of work and, in Australia, GPs have requested clinical guidance to assist them in providing high quality care to their patients [2]. As a result, our team was commissioned to create a clinical guideline for GPs on the diagnosis and management of mental health conditions that have arisen as a result of work; we were determined to create an implementable guideline.
* Correspondence: [email protected] 1 Department of General Practice, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Victoria 3150, Australia Full list of author information is available at the end of the article
Guideline implementation begins at the start of and continues throughout the guideline development process, into post-publication [3–5]. In 2012, the Guidelines International Network endeavoured to standardise guideline development processes internationally by publishing international standards for clinical practice guidelines [6]. Whilst there are numerous international protocols for developing high-quality clinical practice guidelines (e.g. those published by the National Institute for Health and Care Excellence (NICE) [7], National Health and Medical Research Council [8] and WHO [9]) that adhere to these standards, for some steps in guideline development, such as developing key clinical questions for guidelines, there is no consistent protocol [10]. In fact, following a recent review of pr
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