RT Journal Article
SR Electronic
T1 The validity of recommendations from clinical guidelines: a survival analysis
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1211
OP 1219
DO 10.1503/cmaj.140547
VO 186
IS 16
A1 Laura Martínez García
A1 Andrea Juliana Sanabria
A1 Elvira García Álvarez
A1 Maria Mar Trujillo-Martín
A1 Itziar Etxeandia-Ikobaltzeta
A1 Anna Kotzeva
A1 David Rigau
A1 Arturo Louro-González
A1 Leticia Barajas-Nava
A1 Petra Díaz del Campo
A1 Maria-Dolors Estrada
A1 Ivan Solà
A1 Javier Gracia
A1 Flavia Salcedo-Fernandez
A1 Jennifer Lawson
A1 R. Brian Haynes
A1 Pablo Alonso-Coello
A1 ,
YR 2014
UL http://www.cmaj.ca/content/186/16/1211.abstract
AB Background: Clinical guidelines should be updated to maintain their validity. Our aim was to estimate the length of time before recommendations become outdated.Methods: We used a retrospective cohort design and included recommendations from clinical guidelines developed in the Spanish National Health System clinical guideline program since 2008. We performed a descriptive analysis of references, recommendations and resources used, and a survival analysis of recommendations using the Kaplan–Meier method.Results: We included 113 recommendations from 4 clinical guidelines with a median of 4 years since the most recent search (range 3.9–4.4 yr). We retrieved 39 136 references (range 3343–14 787) using an exhaustive literature search, 668 of which were related to the recommendations in our sample. We identified 69 (10.3%) key references, corresponding to 25 (22.1%) recommendations that required updating. Ninety-two percent (95% confidence interval 86.9–97.0) of the recommendations were valid 1 year after their development. This probability decreased at 2 (85.7%), 3 (81.3%) and 4 years (77.8%).Interpretation: Recommendations quickly become outdated, with 1 out of 5 recommendations being out of date after 3 years. Waiting more than 3 years to review a guideline is potentially too long.