TEMPLATE FOR DEVELOPMENT OF EVIDENCE-BASED
CLINICAL GUIDELINES
This template has been developed by: Centre for Clinical Guidelines, July 2009
Recommended by the Scientific Council of the Centre: 18. of June 2009 Approved by the board for Centre for Clinical Guidelines: 25. June 2009
Template for - Evidence-based clinical guidelines
Title It must appear from the title of the clinical guideline which clinical problem and which patient groups the guideline concerns.
Key word Main search word: (one and only one of the following main fields must be selected)
Activity; Nutrition, Skin and membranes; Communication; Psycho-social conditions; Respiration and circulation; Sexuality; Pain and sensory perception; Sleep and rest; Knowledge and development; Excretion of waste products; Observation of effect and side-effects of a treatment; Other search words: (indicate which)
Working group
Name, position, affiliation of group members and any counsellor. State name of contact person and E-mail. Approval Approved by the Centre for Clinical Guidelines following
internal and external evaluation. The clinical guideline has been quality assessed according to instructions established by the Scientific Council of the Centre and approved by the Council for the Centre for Clinical Guidelines.
(www.clinicalguidelines.dk/godkendelsesprocedurer) (This text is always included in the clinical guideline)
Date Date of approval:
Date of revision: Date of expiry:
(filled in by the Centre for Clinical Guidelines – please
insert text)
Evaluated by External evaluation was made by:
(filled in by the Centre for Clinical Guidelines – please insert text)
Target group The target group of the clinical guideline must be evident; this includes indication of staff group and speciality.
Background
Description of: Problem, Patient group
Patient's perspective
Definition of applied concepts and terms.
Purpose Description of purpose of the expected effect of applying the clinical guideline.
Method Description of applied strategy for collecting, selecting and summarising literature:
• Focused questions
• Strategy for systematic literature search (detailed search strategy must be included as an appendix) • Selection and literature review
• Description of solution in case of disagreement concerning assessment
Literature review Brief statement of main conclusions from the literature on which recommendations are based. Evidence level of quoted articles must be indicated. If recommendations include use of assessment tools the validity must appear from the literature review.
Recommendations On the basis of the literature assessed logically formulated recommendations for clinical practice are outlined in point form. Recommendations must be specific and
unambiguous and include level of evidence and strength. The individual recommendations must be supplied with references.
Monitoring Completion of indicators and standards on the basis of central recommendations and plan for monitoring.
References List of applied literature. Listed according to the Vancouver system.
Appendix List of relevant and enclosed attachments. Formal
requirements
Must follow layout and headlines as indicated in this model.
Editorial
independence Must be described.
Conflict of interest Must be described; co-author declaration must be forwarded before final approval. Appendix 1.
Summary Brief description of clinically relevant parts of the clinical guideline for use in practice. Appendix 2.
APPENDIX
Appendix 1 Co-author declaration Appendix 2 Model for summary
CO-AUTHOR DECLARATION Appendix 1 Title of clinical guideline:
It is hereby declared
* that the work is not associated with commercial self-interests or other conditions which could lead to a conflict of interest.
* that there are no copyright issues in relation to the publication of the clinical guideline e.g. permission to use illustrations etc.
* that persons and institutions mentioned have given their acceptance.
* that all authors comply with the criteria for authorship cf. the Vancouver rules. Manuscript authors:
The lead author must be mentioned first followed by a list of the other authors in accordance with internal agreements if there are more authors.
Others who have contributed to the work but who are not co-authors are mentioned under counselling/consultants. Date: Name: _____________________________Signature __________________________ Name: _____________________________Signature __________________________ Name: _____________________________Signature __________________________ Name: _____________________________Signature __________________________ Name: _____________________________Signature __________________________ Name: _____________________________Signature __________________________ Name: _____________________________Signature __________________________ Name: ____________________________ Signature__________________________
Appendix 2
MODEL FOR SUMMARY Title
(Clinical problem and patient group) Working
group
Name, position, affiliation of working group members. Including indication of contact person.
Approved by Approved by the Centre for Clinical Guidelines:
Date of revision: Date of expiry: Background Brief description of problem (no literature references)
Brief description of patient group
Purpose Purpose and expected effect
Recommenda tions
Recommendations with strength of evidence and references
Monitoring Indicators and standards (%)
References List of references for recommendations