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Evidence-Based Guideline Development Process

Defining Research Questions

It is critical that the panel and methodologist develop research questions that are narrow, specific, and can be addressed through the literature. Research questions should include:

  • The patient population(s)
  • The control group
  • The exposure(s) or intervention(s)
  • Outcomes
  • Clarification of inclusion criteria

The following is an example of a research question that is too broad:

  • Are antiplatelet agents effective in preventing vascular events in patients with vascular disease?

The following is an example of a research question that is more narrow and specific:

  • In patients presenting for possible diagnosis of lung cancer, what is the reliability of fiber optic bronchoscopy for diagnosing central (endobronchial) lesions, peripheral lesions >2 cm in diameter, and peripheral lesions <2 cm in diameter?
  Patient Population Intervention or Exposure Control Group or Comparison Intervention Outcome(s)
Tips* Start by describing a group of similar patients.
Balance precision with brevity.

 

 Ask, "Which main intervention should be considered?"

 

Be specific.		 Ask, "Which is the main alternative to compare with the intervention?"
Be specific.

 

 Ask, "Which can be accomplished?" or "What could this exposure/intervention really affect?"
Be specific.

 
Example "In patients with heart failure from dilated cardiomyopathy who are in sinus rhythm…?"

 

 "…would adding anticoagulation with warfarin to standard heart failure therapy…?"

 

 "…when compared with standard therapy alone…?"

 

 "…lead to lower mortality or morbidity from thromboembolism. Is this enough to be worth the increased risk of bleeding?"

 
*Centre for Evidence-based Medicine.
Related Terms:
Evidence-Based Clinical Practice Guidelines
Resources

Guideline Ranking & Disclaimer

Rank
Definition
1 This guideline is new and represents the best available evidence at this time. It will be reviewed on an annual basis to determine if it remains current.
2 This guideline is reviewed on an annual basis and there have been new studies published since the guideline was developed. However, the Health and Science Policy (HSP) Committee determined that these studies are not sufficient to warrant changing the guideline at this time. The information contained in this guideline provides the user with the best evidence available at the time the guideline was published. Readers are encouraged to search the current literature as a supplement to using this guideline.
3 This guideline is reviewed on an annual basis. The HSP Committee determined that new studies have been published that warrant an update of the (fill in) chapter/section of this practice guideline. The HSP Committee also determined that the remainder of the chapters/sections does not require updating and these recommendations remain current.
4 This guideline is reviewed on an annual basis. The HSP Committee determined that new data are available that are sufficient to potentially change guideline recommendations and a full revision is warranted.
5 This guideline has been reviewed on an annual basis. The HSP Committee has decided it is outdated; however, it has been retained for historical and/or educational purposes. These guidelines should be used with caution for clinical decision-making purposes.

The evidence-based practice guidelines published by The American College of Chest Physicians (“ACCP”) incorporate data obtained from a comprehensive literature review of the most recent studies available at the time of publication. Guidelines are intended for general information only, are not medical advice, and do not replace professional medical care and physician advice, which always should be sought for any specific condition. Furthermore, guidelines may not be complete or accurate because new studies that may have become available late in the process of guideline development may not be incorporated into any particular guideline before it is disseminated. ACCP and its officers, regents, governors, executive committee, members and employees (the “ACCP Parties”) disclaim all liability for the accuracy or completeness of a guideline, and disclaim all warranties, express or implied. Guideline users always are urged to seek out newer information that might impact the diagnostic and treatment recommendations contained within a guideline. The ACCP Parties further disclaim all liability for any damages whatsoever (including, without limitation, direct, indirect, incidental, punitive, or consequential damages) arising out of the use, inability to use, or the results of use of a guideline, any references used in a guideline, or the materials, information, or procedures contained in a guideline, based on any legal theory whatsoever and whether or not there was advice of the possibility of such damages.