Developing valid guidelines: methodological and procedural issues from the North of England Evidence Based Guideline Development Project.

Abstract

Thereisincreasing interest inclinical guidelines within theUnitedKingdom. Withthis interest hascomeanincreasing awareness of themethodological issues involved inguideline development, although reports arelimited.' Woolfdescribed threemainmethodsof guideline development: informal consensus, formal consensus, andevidence linked.2 In guidelines developed through informal consensus, themethodusedmostofteninthe UnitedKingdom,theguideline panelhas poorly defined, oftenimplicit, criteria for decision making. Development by formal consensus, usedby many consensusdevelopment conferences andDelphi groups, provides greater structure totheanalytical process butstill fails toprovide anexplicit