A parallel workshop to the first international Evidence-based medicine conference and workshop Adopting Clinical Guidelines where I participated as a guest speaker. https://www.ssrsa.org/

1. Dr. Yasser S. Amer
MBBCh, MSc, CPHQ, FISQua, IPFPH
Pediatrician, CPG Methodologist
EB-CPGs Unit, Quality Management, KKUH
Pediatrics Department, KSUMC
Research Chair for EBHC-KT, KSU, KSA
Founding Member, Alexandria Center for EBCPGs, Alexandria University, ARE
Member, Guidelines International Network, Adaptation Working Group (Steering)
Clinical Practice Guidelines Adaptation Workshop
Searching for Evidence-Based Clinical
Practice Guidelines on the Web

2. Selecting a CPG Topic
 Prevalence of the condition (high volume)
 Patient safety concern (high risk)
 Under-, over-, misuse of intervention(s)
 Burden due to the condition
 Practice variation
 Costs of different practice options
 Likelihood of effectiveness of CPG
 Potential for improving quality of care and/or outcomes
 Existence of relevant good quality CPGs

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4. Health/ Clinical/ Key Questions
Patient (& disease characteristics)
Intervention(s)
Professionals (Target users)
Outcomes (purpose of the CPGs)
Healthcare settings (& context)
CPG Scope: PIPOH Model
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5. Inclusion / Exclusion CPGs Selection Criteria (6)
1. Methods of Development: Evidence-Based CPGs: (Detailed
Methodology not Consensus-based CPGs (Expert opinion)
2. Author(s): Organization and Specialized Society not single authors.
3. Country: International or national CPGs.
4. Date of Publication: range of year of publications: last 5 years or less
(e.g. 20) – except if none!
5. Language: English (& Arabic?) CPGs only
6. Status: only Original source CPG (de novo developed) rather than
adapted CPGs. Maybe if a formal adaptation method was utilized (?).
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6. CPGs on the Web
•CPG full/ summary docs.
•Full-text publications
CPG
Producers
•CPG full/ summary docs.
•Full-text publications
CPG
Finders
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7. Relevant Keywords & MeSH terms
•CPG databases & repositories: only keywords (may
use same as original Source CPGs)
•Bibliographic databases: Both
•Ask help from your Super duper ‘Medical & Health
Sciences Librarian’.
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8. CPG Finders: MedLine/PubMed
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11. Advanced Search Builder in PubMed
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12. Simple Boolean Operators AND/OR/NOT
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13. MeSH Terms
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15. "arthritis, rheumatoid"[MeSH Terms]
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17. CPG Finders: SDL
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18. CPG Producers
1. Governmental (National) organizations: e.g. NICE,
SIGN, NHMRC ,etc.
2. International organizations: e.g. WHO
3. Specialized professional societies/ associations
4. Healthcare Organizations
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19. CPG Producers: NICE, UK
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21. NICE – Arthritis (Example)
•Published products on this topic (60)
•Guidance (41) = CPGs
•NICE advice (3) = critical appraisal of E (not
CPGs) for CDS.
•Quality standards (3) = QI/PM/KPI
•NICE Pathways (3)
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22. CPG Producers: SIGN, UK
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24. CPG Producers: NHMRC, AUS
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27. CPG Producers: WHO, Int’l
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28. CPG Finders: ECRI, USA “replacing NGC!”
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29. CPG Finders: EBSCO DynaMed Plus (Thru SDL)
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30. CPG Finders: G-I-N
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31. Arthritis (41)
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32. CPG Producers/ Finders:
Professional societies for Rheumatology
• International League of Associations for Rheumatology (ILAR)
former International League Against Rheumatism.
• American College of Rheumatology – ACR
• African League of Associations for Rheumatology – AFLAR
• Asia Pacific League of Associations for Rheumatology – APLAR
• European League Against Rheumatism – EULAR
• Pan American League of Associations for Rheumatology – PANLAR
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33. CPG Producers/ Finders:
Professional societies for Rheumatology (Regional-MENA)
• Arab League of Association for Rheumatology-ArLAR
• ArLAR Members (15 National Organizations): Algeria, Egypt, Iraq,
Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar,
Saudi Arabia, Syria, Tunisia, UAE.
• Scientific Committee: No CPGs…..Yet ;)
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34. SSRSA
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35. PRISMA Flowchart & Checklist
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36. PRISMA Flowchart
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38. Cochrane Review Groups (CRGs)
CRGs are members of one of 8 Networks:-
1. Abdomen and Endocrine
2. Acute and Emergency Care
3. Cancer
4. Children and Families
5. Circulation and Breathing
6. Mental Health and Neuroscience
7. Musculoskeletal, Oral, Skin and Sensory
8. Public Health and Health Systems
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42. This guidance can be applied to SRs of guidelines
developed for use outside clinical medicine
(CPGs), such as those used in the fields of public
health and social care (PHGs).
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43. Published AGREE II Appraisal of CPGs for the
selected health topic (SR)
 Google Scholar
 About 5,640 results
 AGREE II + Rheumatology
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44. Study ID Rheumatology Health Topic # Appraised
CPGs/ Rs.
Yu 2020 Gout 15 CPGs
Lopez-Olivo 2019 Use of DMARDs Rheumatoid Arthritis and
Cancer
39 (Rs)
Duarte‐García 2020 American College of Rheumatology CPGs (trend) 9 CPGs
Sankah 2019 Exercises for hand osteoarthritis 8 CPGs
Elmamoun 2020 Psoriatic arthritis in resource-poor settings 2 CPGs
Doiron-Cadrin 2020 Shoulder rotator cuff disorders in adults 9 CPGs
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45. Next! Hands-on!
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46. Email: yamer@ksu.edu.sa;
yassersamiamer@gmail.com
Mobile #: +966-508577246;
Office #: +966-11- 46-91341
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