Page 64 - Shared Guideline Development Experiences in Fertility Care

Chapter 3
development approaches, we also evaluated the feasibility of the approach. Nevertheless, a basis for comparing time data is lacking, which is a limitation of our study and a major limitation of current study designs of guideline development. In our opinion, guideline development is time consuming and expensive. Time should always be weighed against bene ts, especially for introducing new approaches. We have applied the patient-centred network approach to a MuG program for fertility care. is clinical area is characterized by the involvement of intensively collaborating professionals and responsible patients, which might be an argument against generalizability for other clinical areas. However, addressing practice change and sustaining clinical networks generally requires great motivation and is not speci c to fertility care [32,33]. In this light, the level of our participants’ experience may have been a success factor in realizing the project in a relatively short time, but it may also be an argument against generalizability. Nevertheless, basic knowledge of guideline development methodologies is necessary in all approaches. Moreover, not only were our participants pretty experienced in guideline development, they were also opinion leaders within their own medical specialties. is may be an important success factor for disseminating and implementing the de nitive guidelines. Despite this, we realize that, because our participants are rather experienced in their own usual way of developing guidelines, they might have been more critical of such a new approach. For instance, they regarded the lack of a detailed format as a barrier. is factor may have hindered the guideline development.
Although the guidelines clearly address organizational and patient-centred aspects (altogether, in 59% of the recommendations), we did not compare the proportion of these aspects to proportions in conventionally developed guidelines. However, we expect that the proportion of patient-centred aspects is rather small in other guidelines because patient participation in guideline development is still not common practice [34]. is mechanism may also apply to the organizational aspects, which are mainly addressed in guideline-related products, such as local protocols.
Although the participating member societies and organizations are committed to disseminating the nal, harmonized guidelines, our detailed process evaluation was limited to the rst phases of the guideline development and did not include the dissemination and implementation phases. We assume that this approach will enhance the implementation and our network might be an e ective strategy in the further e orts that are still required [28-32,35].
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