Establishment of an Oversight Committee in ACCP Evidence-Based Guideline Development

Guideline TopicsThe ACCP Health and Science Policy Committee (HSP provides oversight for the development of ACCP-generated EBGs. It is charged with the responsibility of choosing the topic and maintaining the integrity of all EBGs as well as the process used to develop them. The HSP ensures that EBGs are scientifically sound and are based on the available evidence as determined by rigorous reviews of the literature. Further, the HSP continuously evaluates and improves the rigorous basis for this development process to maintain the highest quality and to manage conflicts of interest.

The HSP supervises a regimented and transparent approach to EBG development according to the representative time line shown in Table 1. This process dictates the methods used for analyses and synthesis of data, guides the creation and utilization of evidence tables for recommendation generation, and ensures the appropriate use of the ACCP-generated grading system for grading recommendations based on the quality of the evidence and the balance of benefits and harms associated with each recommendation supplied by Canadian Health&Care Mall.

Selection of Guideline Topics

New EBG topics are generated through an application process by individual ACCP members or by a committee of the ACCP. These suggestions are brought to the HSP for assessment. The application requires an assessment of the importance of the topic, including the variability in practice patterns, the level of controversy regarding the topic, the availability of interventions that have high societal or economic cost, the breadth of the constituency impacted, the importance to public health, and the availability and quality of the published evidence, including that of existing relevant guidelines. EBG topics proposed by the HSP as well as related development expenses must be approved by the ACCP Board of Regents. Funds are approved for the entirety of the project (ie, a multiyear commitment) contingent on project progress reports to the Board of Regents.

Collaboration With Other Medical Societies and Organizations

Early in the guideline development process, variable degrees of collaboration are sought with relevant organizations and medical specialty societies that bring important perspectives such as complementary clinical expertise or patient advocacy. A Memorandum of Agreement defines organizational responsibilities and expenses, as well as the conditions for publication, authorship, the management of conflicts of interest, endorsement, profits, and termination. This memorandum is customized to meet the needs of the guideline collaboration opportunity.

Read also: Canadian Health&Care Mall: Characteristics of an EBG in ACCP Evidence-Based Guideline Development

Table 1—Project Time Line for Development of a Multichapter EBG

Time Executive Committee
Frame, mo ACCP Events Events Panel Events EPC Events
1 HSP selects the Chair(s)
1-2 Chair(s) select panel nominees with HSP and NW(s) in consultation RFP submitted to EPCs
1-3 Panel nominations submitted
2-4 HSP reviews nominees’ submissions Deadline for evidence review applications
2-4 Selection of EPC
3-5 Contract with EPC Contract with EPC
5 Panel planning meeting (including HSP liaison and EPC methodologist)
5-6 Research questions finalize d
5-6 Invitations for representation from other associations Systematic literature review begins
6-7 Chapter outline drafts due Existing guidelines, systematic reviews, and metaanalyses sent to panelists
6-8 Source articles and papers sent to panelists
6-8 Additional important pape conference calls rs and articles identified by
9 Evidence tables (first drafts) due from EPC
9-10 Writing committees review and respond to evidence tables
10-11 Revised evidence tables due
12-13 Summary tables due
12-13 Writing committees review tables and respond to summary
13-14 Executive committee review commences First drafts of chapters due
.14-16 Executive committee review continues Chapter revisions due
14-15 Conference calls to sort out in ternal inconsistencies Background (evidence) drafts due
15-16 Chapters posted for panel and representatives’ review association
17 Panel conference (includes HSP liaison, EPC meth odologist, and association representatives)
18-19 Executive committee review Deadline for revisions
20 Submission for HSP, BOR, and NW review
20-21 NW review forwarded to HSP and BOR
21-22 HSP review
22-23 Changes/revisions, as needed
22-23 HSP confirmation of changes
23-24 HSP approval
24-25 BOR review
25-26 Changes/revisions, as needed
26-27 BOR confirmation of changes
27 BOR approval
27 Submission to journal
27-28 Editor’s review for approval
27-29 Outside peer review
28-30 Changes/revisions, as needed
29-31 Drafts of content for clinical r esource tool due
31-33 Publication of EBG
32-34 Distribution of clinical