Page 51 - Shared Guideline Development Experiences in Fertility Care

was random except for their phase in the clinical pathway. e steering committee
translated care aspects that the couples said needed improvement into patient-
centred key questions.
Two focus groups were conducted among members of the MuG group, including
the two patient representatives, and among main target users of the guideline,
including four gynaecologists, three physicians, and a urologist. e steering
committee translated care aspects that the professionals said needed improvement
into medical-technical, organizational, and patient-centred key questions. Example
questions for these three categories, respectively, are: ‘What are the indications for
IVF treatment?’ ‘Which professionals should be part of the treatment team in a 3 university hospital?’ ‘How should patients be informed about adoption?’
All key questions were given a format de ned for the MuG. en the MoG groups addressed the medical-technical questions and the MuG group addressed the organizational and patient-centred questions.
Elaborating key questions and formulating recommendations
e participants worked in pairs. ey used the PICO (patient, intervention, comparison, and outcome) method to de ne their search strategy, conduct a systematic literature review, select relevant evidence, and summarize this evidence in formatted evidence tables. ey rated (scale: 1 to 5) the evidence according to quality criteria adapted from the Centre for Evidence-Based Medicine, version 1999 [17]. e pairs of members then formulated one or more conclusions, their considerations, and one or more concept recommendations. A level of evidence (A to D) was given for each recommendation to be discussed in the particular guideline group [17]. e project coordinator was a member of all guideline groups and coordinated the entire process, which was part of a strategy for harmonizing recommendations across the groups. e project coordinator checked the rating of evidence and grading of recommendations for errors. e steering committee discussed and resolved any discrepancies. e implementation expert checked and improved the implementability of the concept recommendations and the guidelines as a whole using the items of the Guideline Implementability Appraisal (GLIA) Tool. An extensive internal review of the CPGs across the groups was used to harmonize the recommendations. Many patients also participated by formulating and prioritizing recommendations for the MuG [18].
Patient-centred network approach
49