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F1000Res. 2019 Jun 24;8:956. doi: 10.12688/f1000research.19661.1. eCollection 2019.

Towards a new model for producing evidence-based guidelines: a qualitative study of current approaches and opportunities for innovation among Australian guideline developers.

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Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.


Background: Many organisations in Australia undertake systematic reviews to inform development of evidence-based guidelines or would like to do so. However, the substantial resources required to produce systematic reviews limit the feasibility of evidence-based approaches to guideline development. We are working with Australian guideline developers to design, build and test systems that make creating evidence-based guidelines easier and more efficient. Methods: To understand the evidence needs of guideline developers and to inform the development of potential tools and services, we conducted 16 semi-structured interviews with Australian guideline developers. Developers were involved in different types of guidelines, represented both new and established guideline groups, and had access to widely different levels of resources. Results: All guideline developers recognised the importance of having access to timely evidence to support their processes, but were frequently overwhelmed by the scale of this task. Groups developing new guidelines often underestimated the time, expertise and work involved in completing searching and screening. Many were grappling with the challenge of updating and were keen to explore alternatives to the blanket updating of the full guideline. Horizon-scanning and evidence signalling were seen as providing more pragmatic approaches to updating, although some were wary of challenges posed by receiving evidence on a too-frequent basis. Respondents were aware that new technologies, such as machine learning, offered potentially large time and resource savings. Conclusions: As well as the constant challenge of managing financial constraints, Australian guideline developers seeking to develop clinical guidelines face several critical challenges. These include acquiring appropriate methodological expertise, investing in information technology, coping with the proliferation of research output, feasible publication and dissemination options, and keeping guidance up to date.


Clinical guidelines; Interviews; Living guidelines; Qualitative research; Updating guidelines

Conflict of interest statement

Competing interests: Cochrane Australia is actively engaged in developing the ‘living evidence’ model of evidence synthesis and dissemination, and has several ongoing collaborations and partnerships with Australian guideline groups to harness innovations in data systems, machine learning and co-production to enable near real-time updating of systematic reviews, evidence-based guideline recommendations and other evidence products. Cochrane Australia is funded by the Australian Government through the National Health & Medical Research Council. The work presented here does not necessarily reflect Cochrane organisational policy.

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