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Most guideline organizations lack explicit guidance in how to incorporate cost considerations
Most guideline organizations lack explicit guidance in how to incorporate cost considerations
- Source :
- Journal of Clinical Epidemiology. 116:72-83
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Objectives Resource use and cost (RUC) evidence is one of the factors that can be considered when formulating recommendations in clinical practice guidelines (CPGs). However, it is unclear how CPG developers incorporate this information. The purpose of this study was to identify available guidance from guideline organizations on how to incorporate RUC in CPGs. Study Design and Setting This is a methodological survey. We searched MEDLINE, the G-I-N library, the Cochrane Methodology Register, and gray literature from inception to 2017. We included the most recent version of guidance documents. We excluded those that only reported methodology for adapting, endorsing, or updating CPGs, and documents reporting methods followed in the development of one or more specific CPGs. Results We included 77 documents from 67 organizations. Fifty-nine organizations (88.1%) include information regarding RUC during the CPG development process. Fifty-five (82.1%) organizations report taking RUC into account when developing recommendations: 44 (65.7%) do this explicitly, 5 (7.5%) implicitly, and 6 (9.0%) explicitly as optional. Twelve of the 44 organizations that explicitly consider RUC (27.3%) provide guidance to identify, assess and use the RUC evidence when developing recommendations. Twenty-three consider RUC when moving from the evidence to recommendations (52.3%). Seventeen of the 44 (38.6%) recommend making qualitative judgments about whether the desirable effects of interventions were worth the associated costs. Conclusion More explicit guidance is needed alongside tools to help CPGs developers incorporate RUC evidence when formulating recommendations. Our results may be of use for guideline developers to improve this guidance.
- Subjects :
- Evidence-Based Medicine
Process management
Epidemiology
Process (engineering)
Computer science
Cost-Benefit Analysis
Psychological intervention
MEDLINE
Guidance documents
Guideline
Grey literature
03 medical and health sciences
0302 clinical medicine
Systematic review
Practice Guidelines as Topic
Humans
Resource use
030212 general & internal medicine
Models, Econometric
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 08954356
- Volume :
- 116
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Epidemiology
- Accession number :
- edsair.doi.dedup.....718f84db335dc67e7d6fa2d93155c7b0
- Full Text :
- https://doi.org/10.1016/j.jclinepi.2019.08.004