Efficiency, Economy and Excellence: Experimental Exploration of Evidence-based Guideline Development in Resource-Constrained Settings

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dc.contributor.authorMathew, Joseph L.en_US
dc.date.accessioned2023-08-19T04:53:38Z
dc.date.available2023-08-19T04:53:38Z
dc.date.issued2023-07
dc.description.abstractDevelopment of clinical practice guidelines is a scientific process based on a thorough review and appraisal of the global evidence, but factoring in local contextually relevant issues. It is highly resource intensive, demanding considerable time, human skills, and finances- making it challenging in resource-constrained settings. This article summarizes a unique attempt to develop evidence-based guidelines in such settings. This was made possible by mentoring and monitoring a group of committed healthcare professionals with limited prior expertise in evidence-based guideline development. The various steps included an online training workshop to build knowledge and skills. This was followed by a systematic process of identifying topics requiring evidence-based guidelines. Thereafter, the topics were prioritized through a Delphi process. Formal clinical questions were framed using the PICOTS (Patient/ Population, Intervention/ Exposure, Comparison, Outcome, Time-frame, Setting) format. The guideline development process was made time and resource efficient by starting with a formal search for existing guidelines whose recommendations could be adopted, adapted, or adoloped to the local setting. If such guidelines were unavailable, high quality secondary evidence (systemic reviews) was accessed to find answers to the clinical questions. If unavailable, de novo systematic reviews of primary research studies were undertaken. The evidence base was critically appraised and graded. Formal evidence-to-decision formats were used to enable translation of the evidence to recommendations implementable in the local setting. The entire guideline development process was completed with zero financial allocation. This model focusing on efficiency, economy, and excellence, can be emulated in diverse resource-constrained settings.en_US
dc.identifier.affiliationsDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Indiaen_US
dc.identifier.citationMathew Joseph L. . Efficiency, Economy and Excellence: Experimental Exploration of Evidence-based Guideline Development in Resource-Constrained Settings. Indian Journal of Pediatrics. 2023 Jul; 90(7): 700–707en_US
dc.identifier.issn0973-7693
dc.identifier.issn0019-5456
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/223761
dc.languageenen_US
dc.publisherDr. K C Chaudhuri Foundationen_US
dc.relation.issuenumber7en_US
dc.relation.volume90en_US
dc.source.urihttps://doi.org/10.1007/s12098-023-04575-zen_US
dc.subjectGuidelineen_US
dc.subjectDevelopmenten_US
dc.subjectGRADEen_US
dc.subjectRecommendationen_US
dc.titleEfficiency, Economy and Excellence: Experimental Exploration of Evidence-based Guideline Development in Resource-Constrained Settingsen_US
dc.typeJournal Articleen_US
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