008 Principles for the Development of Specialty Society Clinical Guidelines

Abstract

1. INTRODUCTION 1.1. Recognizing that medical specialty societies (Societies), having a responsibility for leading the profession, often serve as an independent source of evidence based clinical practice guidelines, and can help to reconcile conflicting, high-quality guidelines, the Council of Medical Specialty Societies offers these principles as a resource for development of systematic review-based guidelines. Core to these development principles are the following concepts: 1. Guideline recommendations should be informed by a review of available evidence and, where possible, should be based on an extensive, reproducible, and strong body of evidence; 2. Guideline panels should include knowledgeable, multispecialty/disciplinary development individuals; 3. Guideline development should incorporate transparent conflict of interest management; and 4. Guideline development should include broadly defined (including patient, when possible and if applicable) stakeholder involvement. 1.2. The charge to developers of clinical guidelines is generally much more complex than is often realized. There is an inverse relationship between the specificity of clinical questions and the availability of high-quality evidence. Commonly, there are many more clinical and appropriate use questions than there is clear evidence to answer them. Hence, the transparent interaction among knowledgeable stakeholders in evaluating evidence and developing guidelines is the basis for trustworthy guidelines. Annotation: This document should serve as a broad roadmap or set of aspirations for guideline production; we acknowledge that it may be impossible to achieve every recommendation. Societies may meet member needs and further their missions through the use of other types of clinical guidance or applications thereof, such as quality measure development. 1.3. The recent CMSS Code for Interactions with Companies (CMSS Code) addressed some guideline principles: none of the principles here should be interpreted as superseding the CMSS Code. These additional principles have been developed without resource consideration. Specialty Societies generally do not have that luxury, but they can and should transparently document the manner in which their guidelines are developed. Reference to which of these principles were addressed and which were impractical to apply may be helpful in this regard.