METHODS: We developed 24 health outcome descriptors related to breast cancer screening and diagnosis for the European Commission Breast Guideline Development Group (GDG). Eighteen GDG members provided feedback in written format or in interviews. We then evaluated the process and conducted two health utility rating surveys.
RESULTS: Feedback from GDG members revealed that health outcome descriptors are probably useful for developing recommendations and improving transparency of guideline methods. Time commitment, methodology training, and need for multidisciplinary expertise throughout development were considered important determinants of the process. Comparison of the two health utility surveys showed a decrease in standard deviation in the second survey across 21 (88%) of the outcomes.
CONCLUSIONS: Health outcome descriptors are feasible and should be developed prior to the outcome prioritization step in the guideline development process. Guideline developers should involve a subgroup of multidisciplinary experts in all stages of development and ensure all guideline panel members are trained in guideline methodology that includes understanding the importance of defining and understanding the outcomes of interest.
方法:我们为欧盟委员会乳腺指南开发小组(GDG)开发了24种与乳腺癌筛查和诊断相关的健康结果描述符。18名GDG成员以书面形式或在访谈中提供了反馈。然后,我们对该过程进行了评估,并进行了两次健康公用事业评级调查。
结果:来自GDG成员的反馈显示,健康结果描述符可能有助于制定建议和提高指南方法的透明度。时间承诺,方法论培训,在整个发展过程中需要多学科的专门知识被认为是这一过程的重要决定因素。两项健康效用调查的比较显示,在第二次调查中,有21项(88%)的结果的标准偏差下降。
结论:健康结果描述符是可行的,应在指南制定过程中的结果优先步骤之前制定。指南制定者应在制定的所有阶段都有一个多学科专家小组参与,并确保所有指南小组成员都接受过指南方法的培训,包括理解定义和理解感兴趣的结果的重要性。