NGC Announces Revised Criteria for Inclusion of Clinical Practice Guidelines

On June 3, AHRQ’s National Guideline Clearinghouse (NGC) announced its revised criteria for inclusion of clinical practice guidelines. The new criteria reflect the Institute of Medicine’s definition of a clinical practice guideline provided in its 2011 standards-setting publication, Clinical Practice Guidelines We Can Trust. The two main changes to the NGC inclusion criteria are that the guideline:

• be based on a systematic review of the evidence, through a literature review that summarizes evidence by identifying, selecting, assessing, and synthesizing the findings of similar but separate studies, and
• contains an assessment of the benefits and harms of the recommended care and alternative care options.

The revised criteria will become effective June 2014.

Select to access more information on NGC’s revised criteria and its mission. Select for frequently asked questions about the new inclusion criteria or to compare clinical practice guidelines and other related information.

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Inclusion Criteria

Effective June 2014, NGC will employ the 2011 definition of clinical practice guideline developed by the Institute of Medicine (IOM).¹

Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.

For more information, please refer to the Frequently Asked Questions. We invite you to send your comments to info@guideline.gov.

Revised Criteria for Inclusion of Clinical Practice Guidelines in NGC

Effective June 2014: In order for NGC to accept a submitted clinical practice guideline, the guideline must meet all the criteria below. In addition to the guideline, developers must provide NGC with documentation of the underlying systematic review*.

The clinical practice guideline contains systematically developed statements including recommendations intended to optimize patient care and assist physicians and/or other health care practitioners and patients to make decisions about appropriate health care for specific clinical circumstances.
The clinical practice guideline was produced under the auspices of a medical specialty association; relevant professional society; public or private organization; government agency at the Federal, State, or local level; or health care organization or plan. A clinical practice guideline developed and issued by an individual(s) not officially sponsored or supported by one of the above types of organizations does not meet the inclusion criteria for NGC.
The clinical practice guideline is based on a systematic review of evidence as demonstrated by documentation of each of the following features in the clinical practice guideline or its supporting documents.
1. An explicit statement that the clinical practice guideline was based on a systematic review.
2. A description of the search strategy that includes a listing of database(s) searched, a summary of search terms used, the specific time period covered by the literature search including the beginning date (month/year) and end date (month/year), and the date(s) when the literature search was done.
3. A description of study selection that includes the number of studies identified, the number of studies included, and a summary of inclusion and exclusion criteria.
4. A synthesis of evidence from the selected studies, e.g., a detailed description or evidence tables.
5. A summary of the evidence synthesis (see 3d above) included in the guideline that relates the evidence to the recommendations, e.g., a descriptive summary or summary tables.
NB: A guideline is not excluded from NGC if a systematic review was conducted that identifies specific gaps in the evidence base for some of the guideline's recommendations.
The clinical practice guideline or its supporting documents contain an assessment of the benefits and harms of recommended care and alternative care options.
The full text guideline is available in English to the public upon request (for free or for a fee). Upon submission of the guideline to NGC, it also must be noted whether the systematic review or other supporting documents are available in English to the public upon request (for free or for a fee).
The guideline must have been developed, reviewed, or revised within the past five years, as evidenced by appropriate documentation (e.g., the systematic review or detailed description of methodology).

*Systematic reviews are literature reviews that summarize evidence by identifying, selecting, assessing, and synthesizing the findings of similar but separate studies. They can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services.²

For more information, please refer to the Frequently Asked Questions. We invite you to send your comments to info@guideline.gov.

Current Criteria for Inclusion of Clinical Practice Guidelines in NGC (in effect through May 2014)

NGC employs the definition of clinical practice guideline developed by the IOM in 1990.³ All of the criteria below must be met for a clinical practice guideline to be included in NGC.

The clinical practice guideline contains systematically developed statements that include recommendations, strategies, or information that assists physicians and/or other health care practitioners and patients to make decisions about appropriate health care for specific clinical circumstances.
The clinical practice guideline was produced under the auspices of medical specialty associations; relevant professional societies, public or private organizations, government agencies at the Federal, State, or local level; or health care organizations or plans. A clinical practice guideline developed and issued by an individual not officially sponsored or supported by one of the above types of organizations does not meet the inclusion criteria for NGC.
Corroborating documentation can be produced and verified that a systematic literature search and review of existing scientific evidence published in peer reviewed journals was performed during the guideline development. A guideline is not excluded from NGC if corroborating documentation can be produced and verified detailing specific gaps in scientific evidence for some of the guideline's recommendations.
The full text guideline is available upon request in print or electronic format (for free or for a fee), in the English language. The guideline is current and the most recent version produced. Documented evidence can be produced or verified that the guideline was developed, reviewed, or revised within the last five years.

References

Institute of Medicine. Graham R, Mancher M, Wolman DM, Greenfield S, Steinberg E, editor(s). Clinical practice guidelines we can trust. Washington (DC): National Academies Press; 2011. 2p. Also available: http://www.iom.edu/Reports/2011/Clinical-Practice-Guidelines-We-Can-Trust/Standards.aspx.
Institute of Medicine. Committee on Standards for Systematic Reviews. Eden J, Levit L, Berg A, Morton S, editor(s). Finding what works in health care: standards for systematic reviews. Washington (DC): National Academies Press; 2011 Mar 23. Also available: http://www.iom.edu/Reports/2011/Finding-What-Works-in-Health-Care-Standards-for-Systematic-Reviews.aspx.
Institute of Medicine. (1990). Clinical Practice Guidelines: Directions for a New Program, M.J. Field and K.N. Lohr (eds.) Washington, DC: National Academy Press. page 38.

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