Developing a Clinician Friendly Tool to Identify Useful Clinical Practice Guidelines: G-TRUST

• Published in: Annals of family medicine 2017-09, Vol.15 (5), p.413-418
• Main Authors: Shaughnessy, Allen F, Vaswani, Akansha, Andrews, Bonnie K, Erlich, Deborah R, D'Amico, Frank, Lexchin, Joel, Cosgrove, Lisa
• Format: Article
• Language: English
• Subjects: Checklist - methods; Consensus; Delphi Technique; Humans; Original Research; Practice Guidelines as Topic - standards
• ISSN: 1544-1709; 1544-1717
• DOI: 10.1370/afm.2119

Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful practice guidelines, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST). A modified Delphi process was used to obtain consensus of experts and guideline developers regarding a checklist of items and their relative impact on guideline quality. We conducted 4 rounds of sampling to refine wording, add and subtract items, and develop a scoring system. Multiple attribute utility analysis was used to develop a weighted utility score for each item to determine scoring. Twenty-two experts in evidence-based medicine, 17 developers of high-quality guidelines, and 1 consumer representative participated. In rounds 1 and 2, items were rewritten or dropped, and 2 items were added. In round 3, weighted scores were calculated from rankings and relative weights assigned by the expert panel. In the last round, more than 75% of experts indicated 3 of the 8 checklist items to be major indicators of guideline usefulness and, using the AGREE tool as a reference standard, a scoring system was developed to identify guidelines as useful, may not be useful, and not useful. The 8-item G-TRUST is potentially helpful as a tool for clinicians to identify useful guidelines. Further research will focus on its reliability when used by clinicians.