What constitutes a high-quality guideline: exploring consumers' views

Introduction

Clinical guidelines are a cornerstone of evidence-based medicine. Little is known about clinicians' knowledge of guideline development and how they perceive guideline quality.

Methods

A survey protocol was designed according to the CHERRIES (improving the quality of web surveys: the Checklist for Reporting Results of Internet E-Surveys) checklist. The survey explored three main aspects: high-quality markers of guidelines, knowledge of guideline development, and areas for improvement. The survey was conducted by contacting UEG and affiliated societies by email and via social media. All valid answers to each question were counted.

Results

A total of 585 participants responded during the 3-month period. Some 65.8% were aged between 30 and 60 years, and 75.4% were doctors. The most important perceived quality indicators within a guideline were ‘clear and actionable recommendations (97%)’, followed by ‘based on systematic literature review’ (96%), and ‘transparent methodology’ (90%). 230 (39.3%) respondents were previously involved in clinical guideline development. However, the experience of working with a methodologist (18.8%) and using well-established guideline checklists (AGREE-II [21.0%]), RIGHT (Reporting Items for Practice guidelines in HealThcare) (9.9%) were limited. Just under half of the responders (289, 49.4%) were familiar with the GRADE methodology. Apps (78.5%), webinars (73.8%), and short videos (68.2%) were popular tools to access clinical guidelines. Over 90% of responders stated that the reputation of the journal (92%) and the name of the society involved in guideline development (91%) were important. Two-thirds of the responders preferred to see abridged versions of guidelines and 69.2% preferred freely accessible or open access guidelines.

Conclusion

Consumers are keen to read clear and actionable guidelines that are developed transparently. There is a gap in guideline development knowledge. Initiatives by medical journals and professional societies are important to ensure the development of accessible and robust clinical guidelines.