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Appendix N: Surveillance decision framework and multi-criteria decision framework for deciding whether to develop or update recommendations and which methods to use
Appendix N: Surveillance decision framework and multi-criteria decision framework for deciding whether to develop or update recommendations and which methods to use
The following frameworks can be used to decide whether to develop or update recommendations and which methods to use. They should be used in conjunction with the appendix on interim principles for methods and processes for supporting digital living guideline recommendations. This appendix is a living document that is reviewed on a regular basis.
Guideline number |
For example, NGXXX |
---|---|
Topic area |
- |
Date signal from living monitoring received |
Day Month Year |
Currently recommended |
Summary of recommendations in this area in the guideline or suite |
Signals from monitoring |
Brief summary of the signal sources, such as evidence and other intelligence |
Strength, significance and volume of new evidence |
Triggers from monitoring activity: significance of new evidence (including health economics evidence) or issues identified (such as bias and sample size). Are there ongoing trials or studies that we should wait for? Are they big impact trials? Are they likely to report within the next 6 months? Does the new evidence bridge a gap identified in the guideline (do they address the recommendations for research or an important new topic area)? Does the new evidence address previous lack of or limited evidence supporting existing recommendations? |
Certainty of impact on existing recommendations |
Original recommendations: was the area evidence-free or was there a high volume of evidence? Does the new evidence have information on important outcomes, such as patient outcomes? Does the new evidence apply to subgroups that were not addressed by current recommendations or where evidence was previously lacking? From system feedback: are there implementation challenges with the existing recommendations? |
Safety issues |
Does the new evidence suggest that a recommendation may be unsafe or harm patients? |
Resource impact and health economics considerations |
Is there a resource or health economics impact that may change the direction of recommendations? Is a health economics evaluation required? What was the evaluation for the current recommendations? |
Health inequality issues |
Are there health inequality issues that could be addressed by evidence review? |
Complexity and system priority |
|
---|---|
Methods of updating |
|
Committee input |
|
External validation |
Full consultation or targeted engagement? Or no consultation? Give rationale. |
Currency and overlap |
|
Other contextual intelligence |
|
Update with |
Note: there could be combinations of the above |
---|---|
Health economic model |
– |
Committee or topic expert input |
|
Validation |
Note: a mix of validation options may be used, but will need to be justified in each case because this may be resource intensive |
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