Page 145 - Shared Guideline Development Experiences in Fertility Care

2. To what extent does a patient-centred network approach to multidisciplinary guideline development in infertility provide a feasible format regarding the actual performance of a set of guidelines, its time investments, and experiences with the approach? (Chapter 2)
e novel patient-centred network approach is a feasible format for simultaneously and collaboratively developing a harmonized set of multidisciplinary and monodisciplinary guidelines around clinical care pathways for patients with fertility problems. Although comparisons of the actual time investments (20 months) are barely noted in the published literature on this topic, if converted into euros, it seems at least comparable to other published multidisciplinary guideline development initiatives. Moreover, multiple stakeholders reached agreement on the clinical content and perceived the network approach as positive and promising for developing multidisciplinary guidelines.
3. To what extent does a participatory tool for Dutch infertile patients in guideline development provide a feasible tool to enhance shared guideline development, regarding its use, usability, bene ts for the guideline, users’ experiences with the tool, and implementability in other clinical areas? (Chapters 4 & 5)
In this thesis two interrelated types of participatory tools are described and investigated. Chapter 4 answers the question posed for a preliminary wiki-based participatory tool and Chapter 5 answers the question posed for a specialized online participatory tool.
e wiki-based tool (Chapter 4) is a promising and feasible participatory tool for
patients in guideline development. e evaluation of this tool led to suggestions
for new modalities (e.g. automatic limitation of the number and length of recommendations, the use of a xed format for recommendations, inclusion
of a motivation page, and addition of a continuous prioritization system). Furthermore, attention should be paid to the informational character of such a 7 wiki. To improve future implementability, a modi ed tool should preferably be co-developed and evaluated by patients themselves in a user-centred design study. Furthermore, representativeness of participating patients should be evaluated.
ese recommendations for improvement were used to develop the next specialized online participatory tool (Chapter 5). is specialized online tool is a usable and suitable participatory tool for guideline development on infertility. is tool might be implementable in clinical areas other than infertility, but requires cooperation from related professional societies and active patients’ associations.
Discussion
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