The UpPriority tool supported prioritization processes for updating clinical guideline questions

• Published in: Journal of clinical epidemiology 2021-11, Vol.139, p.149-159
• Main Authors: Sanabria, Andrea Juliana, Alonso-Coello, Pablo, McFarlane, Emma, Niño de Guzman, Ena, Roqué, Marta, Martínez García, Laura, Pablo, Alcocer Yuste, Carmen, Ayuso García, Jacobo, Benatar Haserfaty, Cristina, Blasco Suñé, Ramón, Bover Freire, Ana María, Carlos Gil, Ester, Carreño Salas, Marta, Castany Aregall, Ángel, Castellanos Rodríguez, Susana, Duch, Javier, Gamarra Ortiz, José Luis, Hernández Verdejo, Belén, Jiménez Rolando, Ángel Plácido, Llaneza Coto, Isabel María, Martínez Férez, Henar, Martínez Sanz, Núria, Mendieta Rasós, José María, Millán, Ester, Mingorance Moya, Manuel, Montilla Ortega, José Manuel, Navero Rodríguez, Juan Carlos, Oballa, Josep, Perello Capo, Olivia, Pujol, Jaume, Rigo, Elena, Rodríguez Neila, Rafael, Sánchez Borrego, Francisco José, Sanz Segovia, Jesús, Tellez, Miguel Ángel, Zapata
• Format: Article
• Language: English
• Subjects: Appraisers; Clinical practice guidelines; Clinical Trials as Topic - standards; Clinical Trials as Topic - statistics & numerical data; Congestive heart failure; Delivery of Health Care - standards; Epidemiology; Evidence-Based Medicine - standards; Evidence-Based Medicine - statistics & numerical data; Evidence-based practice; Glaucoma; Guidelines as Topic; Health care access; Health priorities; Health Priorities - standards; Health Priorities - statistics & numerical data; Health service research; Humans; Menopause; Methods; Practice guidelines; Questionnaires; Questions; Reproducibility of Results; Time; Training; Working groups
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2021.07.022

•Updating strategies can be optimized with prioritization processes that help identify CGs, CG sections, CQs, or recommendations in the greatest need for updating.•We recently developed the UpPriority tool, a pragmatic tool for prioritizing CG questions for updating. The tool was based on a published methodological systematic review and a multistep process involving relevant stakeholders.•We applied the UpPriority tool to a set of CGs using a step-by-step process that included: 1) establishment of the UpPriority Implementation Working Group, 2) mapping of the CG questions and recommendations, 3) development of a survey to prioritize CQs, 4) assessment of CQ's priority according to six items, 5) calculation and ranking of priority scores, 6) decision of prioritized CQs for updating, and 7) development of the priority report. We assessed the tool implementation process (appraisers’ experience when using the tool) and the inter-observer reliability of the tool, and we provided suggestions for improvement.•The UpPriority is a useful tool to identify which CQs within a CG need to be prioritized for update in a real-world scenario. We aim to 1) use the UpPriority tool to identify which clinical questions (CQs) within the clinical guidelines (CGs) need to be prioritized for updating and 2) assess the implementation of the tool in a real-world set of CGs. We systematically assessed CQs from a sample of CGs developed in the Spanish National Health System CG program. We applied the UpPriority tool to each CG using a step-by-step process that included: 1) establishment of the UpPriority Implementation Working Group, 2) mapping of the original CG questions and recommendations, 3) development of a survey to prioritize CQs, 4) assessment of CQ's priority according to six items, 5) calculation and ranking of priority scores, 6) decision of prioritized CQs for updating, and 7) development of the priority report. We assessed the tool implementation process (appraisers’ experience when using the tool) and the inter-observer reliability of the tool, and we provided suggestions for improvement. We included four CGs with a total of 107 CQs on the following topics: chronic heart failure (10 CQs), inherited retinal dystrophies (39 CQs), menopause (20 CQs), and open-angle glaucoma (38 CQs). We included a total of 30 participants, most of them clinicians that were members of the original CG development groups. CQs were classified in three groups: 1) high priority (CQs prioritized