News from the network
Collaboration opportunity / Calls for Interest
Current recommendations for the management of urinary tract infections and for prenatally-detected hydronephrosis change rapidly, and are sometimes very different from one country to another or even from one organization to another. This might decrease the clinician trustiness in these guidelines, and complicate their wider implementation.
As a paediatric nephrologist, I think that a critical evaluation of these guidelines could help in their fair comparison and ease their implementation. I would like to evaluate the currently published recommendation for the management of urinary tract infections in infants, children and adolescents, and for prenatally-detected hydronephrosis, searching G-I-N and other databases such as the National Guideline Clearinghouse, using the AGREE II instrument.
My intention is to find other colleagues who would help me in this project. Please contact me by email if you have the expertise and the willingness to collaborate. Thank you very much in advance.
Francois Cachat, MD, Paediatric Nephrologist
Guideline Implementability Tool (GItool) Directory
The Guideline Implementability Research and Application Network (GIRAnet) brings together international guideline developers, implementers, and researchers to identify, develop, evaluate and share guideline implementability tools (GItools). GItools refer to the context-specific information, instructions or instruments provided in guidelines or as adjunct products by which users can prepare for and implement guidelines, and evaluate guideline-specific performance.
Over the past eight months we searched for, described and evaluated GItools based on criteria recommended to us by the international guideline community, and developed a prototype database of GItools. The GItool Directory is by no means comprehensive – it is meant to provide examples of GItools. It currently includes 10 Resource Implications, 28 Implementation, and 7 Evaluation GItools. Others may submit GItools for review and inclusion in the Directory. This may lead to a sustainable effort where international guideline developers, implementers and researchers contribute to, and draw from this shared resource.
Please visit the GItools Directory at www.giranet.org and send comments or suggestions to: firstname.lastname@example.org. In particular, we are interested in feedback on the clarity of content and instructions, and functionality of the Browse, Search and Submit a GItool features. The Submit feature is functional so please help us populate the Directory if you have developed, or are aware of GItools.
G-I-N North America webinar series
G-I-N North America will continue its popular webinar series throughout 2013 with a lineup of speakers addressing diverse topics of interest to the North American guideline community. Webinar participants had the opportunity in February to hear from Dr. David Eddy, one of the leading figures in evidence-based medicine and guideline development, on the topic of “individualizing guidelines” for use at the point of care.
A pioneer in the development of a clinically realistic, large scale simulation model of physiology, populations, and health care systems known as “Archimedes,” Dr. Eddy demonstrated how a program called “IndiGO” creates individualized guidelines, designed to assist clinicians and patients in making decisions about optimal prevention and treatment strategies at the point of care.
IndiGO takes a patient’s personal health information from an organization’s electronic health record or other data systems to calculate the risks of different diseases, as well as the impact of different medication and lifestyle interventions on improving individual health outcomes.
The program then displays this information in a graphical format that enables clinicians and patients to compare different treatments and discuss how they can affect the patient’s health outcomes.
Recent studies have demonstrated that use of individualized guidelines can increase quality and reduce the cost of care.
This and other G-I-N North America webinars can be viewed online at www.g-i-n.net/library/webinars.
Marguerite Koster, MA, MFT
Practice Leader, Technology Assessment and Guidelines Unit, Kaiser Permanente Southern California Gardena, CA, USA
G-I-N in Australia and New Zealand: a Regional Group?
Inspired by the success of Regional Groups that are championing the G-I-N mission at local levels, a group of members in Australia and New Zealand (ANZ) are discussing a proposal for a G-I-N ANZ. Like other regions, we face national and local challenges in capacity and resourcing for the development and implementation of quality guidelines.
A G-I-N ANZ would aim to provide local opportunities for guideline groups and those interested in evidence translation to network and would aim to link with other national initiatives in health quality improvement.
Stay tuned for more information as we undertake consultation with members in New Zealand and Australia on this proposal. Also, if you are attending the San Francisco Conference, please do join in a discussion forum about a G-I-N ANZ. For any queries/suggestions please email email@example.com.
The African Cochrane Indaba
Took place in Cape Town, South Africa on the 6th to 8th May 2013 with more than 100 participants from 11 African countries. The meeting was a clear manifestation of the achievements of the Cochrane Collaboration and the progress and importance of evidence based healthcare in Africa. The South African Cochrane Centre has led the work with several ground breaking systematic reviews about HIV, TB and tropical diseases that have changed practice and saved lives for thousands of Africans. This meeting was also a celebration of the 15th anniversary of the South African Cochrane Centre which has been led by professor and Dean of Medical School at Stellenbosch University, Jimmy Volmink since its founding.
Cochrane reviews and guidelines go hand in hand
I took the opportunity to speak to Karen Daniels, a qualitative researcher, who many of you might remember as a plenary speaker from the G-I-N conference in Korea, about the role of qualitative research in guidelines development. ‘Qualitative data plays a crucial role both in understanding which guidelines should be developed and about how they can be implemented,’ she says. ‘If you don’t understand the context where the guideline is supposed to work and the needs of the patients and the healthcare workers, there is a great risk that the guideline won’t work’. She had a poster at the conference, the conclusion of which reads as follows: ‘Qualitative evidence can contribute in a range of ways to guidelines development and implementation, and examples of such use are growing. Guidelines developers need to actively consider how to utilize qualitative research to improve the quality, usability and acceptability of guidelines’.
Karen Daniels also blogged about the Indaba in PLOS, see link http://blogs.plos.org/speakingofmedicine/2013/05/14/acollaboration-of-friends-getting-to-know-cochrane/
Most of the participants at this Indaba (meeting among leaders) were Cochrane reviewers from Africa, but the importance of capacity building and training and getting evidence into practice was also highlighted in the discussions. I was running a workshop on guideline development and adaptation together with Andy Parrish from South Africa, introducing the G-I-N standards, the AGREE instrument and the ADAPTE tool. There was a keen interest among many participants to work closer with G-I-N in the future.
Frode Forland, G-I-N vice chair