Page 57 - Shared Guideline Development Experiences in Fertility Care

relevant evidence. Further, there was a lack of consensus on some recommendations
in the four MoGs for life-style advices (e.g., alcohol and anabolic steroids use)
issued in all four MOGs as well as lack of underlying evidence. is necessitated
two additional consensus meetings, which were attended by four members of the
MuG (including the chairperson) and the chairpersons of all MoG groups. ese
consensus meetings produced overall recommendations for life-style advice based
on evidence regarding pre-pregnancy counselling. e MuG group reviewed the
dra s of the MoG groups and vice versa. en, the project coordinator initiated
a conference call in order to reach consensus on the recommendations based
on the expert opinion of the MoGs. Via WikiFreya, 298 patients formulated 289 3 recommendations, which 80 patients prioritized into 21 recommendations. ese recommendations were included in the de nitive guideline [18].
Resulting guidelines
One MuG and four related MoGs were developed in 20 months; all were written in Dutch: http://www.nvogdocumenten.nl/uploaded/docs/Landelijke%20netwerk richtlijn%20Subfertiliteit%20def.pdf; www.nvog.nl; www.nhg.org; www.nvu.nl; www.embryologen.nl
e de nitive MuG follows the overall clinical care pathway for patients with infertility problems. It addresses patient-centred, organizational, and medical- technical issues on the clinical pathways, from rst visiting the physician to completed treatment (with or without a pregnancy) and a ercare from the physician or medical psychologist (Table 3). e MuG consists of 198 recommendations based on the best available evidence or expert opinion; the level of evidence (A to D) is given for each recommendation. All recommendations were linked to the key questions formulated. Of these recommendations, 59% concerned organizational and patient-centred aspects of care (Table 4). e medical-technical recommendations for transitions in fertility care and supporting care alignment were derived from the MoGs. Twenty-one prioritized patients’ recommendations, obtained via WikiFreya, were included in the MuG and graded as level P evidence [18].
Patient-centred network approach
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