Table 1.
The development of national guidelines in Europe and Russia: participants and intended audiences
| Country | Evidence system used | Organisation involved in the development | Participants involved in the development | Intended audience | Reference |
|---|---|---|---|---|---|
| Czech Republic | Consensus | The Czech Pneumological and Phthisiological Society (CPPS) commissioned an expert group to draft recommended guidelines for the management of stable COPD. Subsequent revisions were further discussed at the National Consensus Conference. Reviewers’ comments contributed to the establishment of the final version. | Pulmonologists and pharmacologists | Pulmonologists (full version), internists, GPs, and emergency physicians (reduced version). The Czech national recommendation was fully accepted by the State Institute for Drug Control (SUKL). | [43] |
| England | NICE technical manual methodology (includes GRADE) | National Institute for Health and Care Excellence (NICE) | Pulmonologists, GPs, respiratory nurses, physiotherapists patients, NICE technical team (including health economists), feedback from registered stakeholders (payors, professional bodies, hospitals etc.) | Pulmonologists, GPs, other specialists, all other healthcare professionals involved in caring for people with COPD, payors and managers | https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview [44] |
| Finland | Evidence-based medicine and GRADE methodology | The Current Care Guidelines were developed by the Finnish Medical Society Duodecim in association with various medical specialist societies. The guidelines were produced with public funding and are open to all healthcare professionals and the general public, and include patient versions. A large reviewing group including GPs was asked to comment on the guideline. | Pulmonologists, GPs and internists | Pulmonologists, GPs, other specialists, all other healthcare professionals (including nurses, physiotherapists, pharmacists) and citizens | www.kaypahoito.fi/web/english/home [41, 45] |
| France | (A) Position paper/statement on pharmacological treatment optimisation of stable COPD | A restricted expert group was commissioned by the national society (SPLF) to produce an initial proposition. A larger reviewing group including GPs was asked to comment. | Pulmonologists and GPs | Pulmonologists and GPs | [46] |
| (B) GRADE method for guidelines on exacerbations | An extensive multidisciplinary group of experts and end-users was commissioned to produce the initial document, which was commented on by a panel of external reviewers. | Pulmonologists, GPs, intensivists, emergency physicians, physiotherapists and nurses | Pulmonologists, GPs, intensivists, emergency physicians, physiotherapists and nurses | [47] | |
| Germany | Consensus | The German Respiratory Society (DGP) and the German Airway League (AWL) commissioned an expert group to develop a guideline for the diagnosis, assessment and management of COPD. | Pulmonologists | Pulmonologists, GPs, intensivists, emergency physicians, physiotherapists, nurses and patients | Vogelmeier CF et al. Pneumologie 2017; in preparation |
| Italy | Consensus | The document was prepared by a working group appointed by the three major national respiratory societies (AIMAR, AIPO and SIMeR) and the Italian Society of General Medicine (SIMG). Representatives of the Italian Ministry of Health and AGE.NA.S. were involved as external independent observers to ensure ethical, social and solidarity principles. | Pulmonologists and GPs | Pulmonologists and other specialists working either inside or outside the hospital setting, GPs, other healthcare professionals, patient associations, and institutions at national, regional, or local level | [48] |
| Poland | Consensus | Polish Respiratory Society | Pulmonologists | Pulmonologists and a short version for GPs | [49] |
| Portugal | Consensus | National Health Authority (DGS) commissioned an expert group, including National Physicians Organization (OM) and Portuguese Respiratory Society (SPP) representatives, to produce a guidance document. | Pulmonologists | All Physicians of the National Health Service (SNS) | [50] |
| Russia | Evidence-based medicine and consensus | Russian Respiratory Society and Russian Ministry of Health. | Pulmonologists | Pulmonologists, GPs, other healthcare professionals, patient associations, and institutions at national, regional, or local level | [51] |
| Spain | GRADE and consensus | 11 medical scientific societies and the National Association of Patients. | Pulmonologists, GPs, internal medicine, rehabilitators, nurses, physiotherapists, geriatricians, emergency specialists and patients | Pulmonologists, GPs, internal medicine and emergency specialists | [52] |
| Sweden | (A) Evidence-based medicine and consensus | Swedish Medical Products Agency (MPA) | Pulmonologists, GPs, allergologists and physiotherapists | Pulmonary specialists, GPs and internal medicine specialists | https://lakemedelsverket.se/upload/halso-och-sjukvard/behandlingsrekommendationer/Kroniskt_obstruktiv_lungsjukdom_KOL_behandlingsrekommendation.pdf [53] |
| (B) Evidence-based medicine and GRADE | The Swedish National Board of Health and Welfare | Pulmonologists, GPs, allergologists and physiotherapists | Pulmonary specialists, GPs and internal medicine specialists | [54] | |
| Switzerland | Consensus | The Swiss Society of Pneumology (SGP) commissioned an expert group including pulmonologists from all five University Hospitals in Switzerland, a representative from a REHAB Clinic and at least one representative from each Language Region in Switzerland | Swiss medical doctors (members of the Foederatio Medicorum Helveticorum [FMH]) | Pulmonologists, GPs, internal medicine and specialists | [55] |
Abbreviations: GP general practitioner, GRADE grading of recommendations assessment, development and evaluation