A new tool developed by the Agency for Healthcare Research and Quality (AHRQ) and the ECRI Institute will assess the extent to which a guideline adheres to the Institute of Medicine’s (IOM) standards for trustworthy evidence-based clinical guidelines.
IOM recommends that guidelines:
- Be based on a systematic review of the existing evidence
- Be developed by a knowledgeable, multidisciplinary panel
- Consider important patient subgroups and patient preferences
- Be based on an explicit and transparent process
- Provide a clear explanation of the logical relationships between alternative care options and health outcomes, and provide ratings of both the quality of evidence and the strength of recommendations
- Be revised as appropriate when there is important new evidence
The National Guideline Clearinghouse tool, called the National Guideline Clearinghouse Extent Adherence to Trustworthy Standards (NEATS) Instrument, provides quick-glance assessments to be used by clinicians, educators, policy makers, payers, and patients so they can better understand what lies behind guideline recommendations.
“These quick-glance assessments make it easier for users to judge what lies behind recommendations of guidelines, and to choose the most rigorously developed ones with a goal of improving healthcare quality and outcomes for patients,” Karen Schoelles, MD, SM, FACP, director of the ECRI Institute-Penn Medicine Evidence-based Practice Center, and project director of the National Guideline Clearinghouse, said in a statement
The tool assesses standards guideline developers should strive to meet, such as including disclosures of funding and financial conflicts of interest, as well as specific actions, such as whether the guideline developer assembled a multidisciplinary group or appropriately rated the strength of the recommendations during the development process.
“Guideline developers now receive an independent judgment about the trustworthiness of their guidelines, which they can use to benchmark their guideline development process against,” said Mary Nix, deputy director of the Division of Practice Improvement and management lead for the National Guideline Clearinghouse at the Center for Evidence and Practice Improvement at AHRQ. "This should enable them to more rigorously construct guidelines that work to improve patient care, safety, and outcomes."