Table 7.
Overview of guidance/guideline developer methods
| WHO [9] | SHEA [10] | HICPAC [11] | SIGN [12] | NICE [13] | EPIC [[14], [15], [16]] | NIPCM [5] Single-person methodology |
NIPCM [5] Two-person methodology |
|
|---|---|---|---|---|---|---|---|---|
| Development of research questions by a defined group of experts/key stakeholders? | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Evidence searches performed across multiple databases | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Screening and selection of articles performed by more than one person? | ✓ | ✓ | ✓ | X | ✓ | ✓ | X | ✓ |
| Data extraction carrie out independently by more than one reviewer? | ✓ | ✓ | ✓∗ | ✓ | ✓∗ | ✓ | X | ✓∗ |
| Evidence appraised and graded using an appropriate method/recognised tool(s)? | ✓ | ? In-house method is used but not consistently |
✓ | ✓ SIGN methodology (NICE accredited) |
✓ | ✓ | ✓ | ✓ |
| Evidence tables/summaries produced and reviewed by defined group of experts? | ✓ | ? Only required if the guideline is to be submitted to the National Guidelines Clearing House |
✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| How are recommendations developed? | Formulated by the guideline development group with support from the steering group | The writing panel agree the recommendations by formal consensus | Single reviewer writes recommendations second reviewer then reviews these. Expert panel and HICPAC provide regular feedback | Developed by the guideline development group using considered judgement forms | Developed by the guideline committee following documented discussion | Formulated by the guideline advisory group using evidence tables | Recommendations are drafted by HPS (scientists, senior infection control nurses and nurse consultants in infection control) | Recommendations are drafted by HPS (scientists, senior infection control nurses and nurse consultants in infection control) |
| How are recommendations approved? | Agreed by the guideline development group | Agreed by consultation with the GLC and external stakeholders | HICPAC members vote to approve the final guideline | Reviewed through open consultation and targeted peer review | Stakeholder consultation: these are open but registered stakeholders are notified in advance | Finalised through consultation with key stakeholders | Approved by consultation with stakeholders via the consensus and/or steering group | Approved by consultation with stakeholders via the consensus and/or steering group |
| Are there timeframes for updating the guideline/literature review? | X A specific date is not required |
✓ Every 4 years |
✓ Not timelined, revised periodically/at the request of the HICPAC |
✓ Varies |
✓ Guidelines are checked every 5 years at a minimum, surveillance is in place to identify if guidelines require updating sooner than this. |
✓ Both EPIC 2 and EPIC 3 stated a two year timeframe for update of the evidence; however, this has not been achieved. |
✓ Continual review of evidence base full updates every three years (unless evidence emerges that changes recommendations) |
✓ Continual review of evidence base plus full updates every three years (unless evidence emerges that changes recommendations) |
| How is guideline production funded? | Varies, may be funders may include governmental or non-governmental organisations (e.g. united nation), industry or charitable foundations ad hoc | unknown | CDC funded, ad hoc | Core funding from NHS Healthcare Improvement Scotland (indirectly via Scottish Government) | Department of Health and Social Care, England | Department of Health and Social Care, England. Ad hoc | Core funding from Scottish Government | Core funding from Scottish Government |
| Are conflicts of interest declared? | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
•Single reviewer performs data extraction/critical appraisal this is then checked by a second reviewer.