Invitation to publish a Clinical Guideline for free

2013-06-22

The standard definition of Clinical practice guidelines (CPGs) is that of Field and Lohr [1990]: "systematically developed statements to assist practitioners and patient decisions about appropriate health care for specific circumstances".

CPGs are recommendations on the appropriate treatment and care of people with specific diseases and conditions. CPGs are based on the best available evidence. Guidelines help healthcare professionals in their work, but they do not replace their knowledge and skills.

Now iMedPub is looking for clinicians wishing to write a monograph on any clinical topic. It must be of practical interest.

Guidelines are designed to support the decision-making processes in patient care. The content of a guideline is based on a systematic review of clinical evidence - the main source for evidence-based care. Purposes of GPCs:

  1. To describe appropriate care based on the best available scientific evidence and broad consensus;
  2. To reduce inappropriate variation in practice;
  3. To provide a more rational basis for referral;
  4. To provide a focus for continuing education;
  5. To promote efficient use of resources;
  6. To Act as focus for quality control, including audit;
  7. To highlight shortcomings of existing literature and suggest appropriate future research.

The movement towards evidence-based healthcare has been gaining ground quickly over the past few years, motivated by clinicians, politicians and management concerned about quality, consistency and costs. CPGs, based on standardised best practice, have been shown to be capable of supporting improvements in quality and consistency in healthcare. Many have been developed, though the process is time- and resource-consuming. Many have been disseminated, though largely in the relatively difficult to use format of narrative text. As yet they have not had a major impact on medical practice, but their importance is growing.

GPCs will be published with iMedPub both as an scientific article to be published both as an article in the journal Open Journal of Medicine and as an eBook (short monograph) to be distributed online at Amazon.

Instructions for writing a clinical practice guidelinesMethodology core principles

iMedPub’s GPCs are developed using an explicit methodology based on three core principles:

  1. Development is carried out by well multidisciplinary, representative groups well by one expert alone.
  2. A systematic review is conducted to identify and critically appraise the evidence
  3. Recommendations are explicitly linked to the supporting evidence.
Content and presentation

Guidelines with a wide range of styles and formats have been shown to be effective in changing practice. Whilst there is little information available on the effect that style and presentation have on the adoption of guidelines, clarity – of definitions, language, and format – is obviously important. Guidelines should, therefore, be written in unambiguous language and should define all terms precisely. The best format for presenting guidelines will vary depending on the target group(s), the subject matter, and the intended use of the guideline. Ideally, end users should be consulted regarding the most appropriate method of presentation for them. This is an additional function of the extensive peer review process to which all iMedPub guidelines are subject.

Each iMedPub guideline includes an introduction, outlining the need for the guideline (including evidence of variation in practice) and defining carefully the remit of the guideline, including the patient and practitioner groups to which it applies. Within the main body of the guideline, the structure should as far as possible reflect the development process that the guideline development group has followed, ie (for each chapter):

  1. A clear statement of the question/issue under consideration.
  2. A brief explanation of the treatment options available.
  3. A summary of the conclusions drawn from the critical appraisal of the evidence (the evidence statement, annotated with the level of evidence and key references). This should provide the justification for the recommendation to follow – ie the evidence for improved outcome resulting from the recommended action.
  4. The recommendations that the group has derived from this evidence (graded according to the strength of the supporting evidence).
  5. A brief discussion of any practical points (eg resource/geographical considerations to be taken up in the discussion of local guidelines for implementation), or outstanding treatment options for which there is no evidence (the last should be stated clearly).
  6. Finally, if the group feels it is important to give guidance in any of these latter areas where there is no suitable evidence, a “good practice point” may be presented.

Having a well developed and defined template for presentation of the final guideline can greatly facilitate the development process, enabling guideline development groups to plan at the outset what type of information will be required and also to envisage what format the content will take. By following the model for systematic review and formation of guideline recommendations, guideline developers will find that most of the required information will then be produced in a structured, accessible fomat, ready to slot into the guideline structure.

 

Submission

You can submit your manuscript online at Open Journal of Medicine’s submission page.

References
  1. Developing clinical practice guidelines
  2. A guide to the development, implementation and evaluation of clinical practice guidelines
  3. National Guideline Clearinghouse