Process for guideline development by the reconstituted Canadian Task Force on Preventive Health Care

Sarah Connor Gorber; Harminder Singh; Kevin Pottie; Alejandra Jaramillo; Marcello Tonelli

doi:10.1503/cmaj.120642

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Table 1:

Criteria for selecting topics for recommendations of the Canadian Task Force on Preventive Health Care

Criteria	Explanation	Source of information^*
Stage 1: Developing a short list of potential topics
Timing of most recent review	Priority is given to topics that have not been examined by the task force within the past 5 years.
Availability of new evidence	Priority is given to topics for which new or controversial evidence, which might lead to a change in existing recommendations, has emerged since the last time the topic was reviewed by the task force.
Input from primary care practitioners	Priority is given to topics that will address the needs of primary care practitioners.
Stage 2: Ranking the final leading topics
Disease burden	Prevalence, mortality, comorbidity, quality of life and expected effectiveness of the preventive service in decreasing that burden are assessed.	Summaries of literature reviews and stakeholder consultations are developed and provided.
Potential impact of recommendations in clinical practice	Rating is done of whether there is the potential of a recommendation in a field to improve clinical practice and patient outcomes.	Summary of stakeholder consultations is developed and provided.
Interest of the public or care providers	Priority is given to topics that have been recommended by practitioners or stakeholders.	Summary of stakeholder consultations is developed and provided.
Variation in care	Priority is given to preventive services that have the potential to decrease variations in care.	Summaries of literature reviews and stakeholder consultations are developed and provided.
Sufficiency of evidence	A preliminary scan is conducted to determine whether there is evidence to answer key research questions.	Summary of literature reviews is developed and provided.
New evidence	Priority is given especially to high-quality evidence in a stable field.	Summaries of literature reviews and stakeholder consultations are developed and provided.

↵* This information is developed by the task force scientific officers with assistance from the Evidence Review and Synthesis Centre, and is provided to the topic prioritization work group.

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Table 2:

Comparison of methods currently used by major international guideline-producing bodies

Guideline group	Topic selection	Conflicts of interest	Members	Stakeholder involvement	Review process	Method for summarizing evidence
WHO (9)	Topics recommended internally by WHO departments	Declared and published	Different group for each guideline Groups are multidisciplinary and include content experts, methodologists and end users; consumer involvement is encouraged	Review documents and participate in guideline work group	Research questions (experts and end users) Systematic review protocol and evidence tables (experts) Guidelines (experts and organizational reviewers)	GRADE
US Preventive Services Task Force (8)	Topics nominated by the public, task force members and stakeholders	Declared, not published	Multidisciplinary panel of 16 health-related disciplines, nominated for 4-year term No consumers in the guideline work group	Review and disseminate documents Briefing webinars offered on all guidelines New methods of stakeholder involvement are being tested	Public comment on research plans, evidence review, guidelines	Recommendations graded as A, B, C or D reflecting whether the service is recommended “I” statements used if evidence is insufficient to make a recommendation
National Institute for Health and Clinical Excellence (10)	Topics selected by Department of Health but based on input from clinicians and public	Declared and published	Clinical group differs for each guideline; technical members (search, research, synthesis) are constant Groups include health professionals, patient and caregiver representatives and registered stakeholders	Involved in all steps throughout the process and as members of guideline work group Dissemination	Public consultation, peer review	Modified GRADE Recommendations are not rated as strong or weak
Canadian Task Force on Preventive Health Care	Topics nominated by public, task force members, stakeholders, literature review	Declared and posted on website	Multidisciplinary panel of 14 methodologic, primary care and guideline experts, nominated for 3-year term Subset of a minimum of 3 task force members in each guideline work group No consumers in guideline work group	Topic selection, review of documents	Research question Systematic review protocol Evidence report and guidelines reviewed by experts, and subject-matter and generalist organizations	GRADE