Updating rather than de novo guideline development now accounts for the majority of guideline activities for many guideline development organizations, including Kidney Disease: Improving Global Outcomes (KDIGO), an international kidney disease guideline development entity that has produced guidelines on kidney diseases since 2008. Increasingly, guideline developers are moving away from updating at fixed intervals in favor of more flexible approaches that use periodic expert assessment of guideline currency (with or without an updated systematic review) to determine the need for updating. Determining the need for guideline updating in an efficient, transparent, and timely manner is challenging, and updating of systematic reviews and guidelines is labor intensive. Ideally, guidelines should be updated dynamically when new evidence indicates a need for a substantive change in the guideline based on a priori criteria. This dynamic updating (sometimes referred to as a living guideline model) can be facilitated with the use of integrated electronic platforms that allow updating of specific recommendations. This report summarizes consensus-based recommendations from a panel of guideline methodology professionals on how to keep KDIGO guidelines up to date.
Bibliographical noteFunding Information:
JSB declared having served on the clinical trial Executive Committee for Amgen; he is presently President of the National Kidney Foundation (NKF) and former NKF Vice-Chair for Clinical Practice Guidelines and Commentaries. SC acknowledged that the National Clinical Guideline Center receives funding from NICE to develop NICE clinical guidelines and reported no additional relevant financial disclosures. WC was formerly Director, Guidelines and Evidence-Based Medicine, and internal medicine physician at Northwest Kaiser Permanente, and reported no additional relevant financial disclosures. SZL is Chief Guidelines Officer at Doctor Evidence. MT is Chair of the Canadian Task Force on Preventive Health Care and reported no additional relevant financial disclosures. TJW declared having received funding from KDIGO to conduct an evidence synthesis report in support of a clinical practice guideline related to living kidney donation. BLK is immediate past KDIGO Co-Chair and reported no additional relevant financial disclosures. KU, MC, GHG, AH, and ACW reported no relevant disclosures.
- clinical practice guideline
- guideline development
- guideline updating
- systematic reviews