SNLG method

Methodological handbook - How to produce, disseminate and update clinical practice recommendations

Download the handbook (pdf 709 kb). The handbook is available in Italian.

 

Introduction

  • 1.1 The use of clinical practice recommendations
  • 1.2 The National Guidelines Programme
  • 1.3 Why a handbook
  • 1.4 How to read this handbook

The various available instruments

  • 2.1 What recommendations for clinical practice?
  • 2.2 Guidelines
  • 2.3 Consensus conferences
  • 2.4 Appropriateness evaluation
  • 2.5 Technology assessment
  • 2.6 Choosing a method

Criteria to choose topics

  • 3.1 What priorities?
    • 3.1.1The epidemiological model
    • 3.1.2 The request model
    • 3.1.3 The availability of evidences model
    • 3.1.4 The economic model
    • 3.1.5 The choice of the National Guidelines Programme

Method to draw up evidence-based recommendations

  • 4.1 Methodological prerequisites
  • 4.2 Multidisciplinarity
  • 4.3 Systematic reviews of literature
  • 4.4 Grading of recommendations
  • 4.5 Monitoring indicators
  • 4.6 Guidelines between new production and adaptation

Economic and ethic issues

  • 5.1 Introduction
    • 5.1.1 Guidelines, scientific evidences and economic evaluations
    • 5.1.2 Economic evaluation of the production, dissemination and implementation of a guideline
  • 5.2 Bioethical considerations
  • 5.3 Conflicts of interest

Presentation and dissemination of guidelines

  • 6.1 Presentation of documents
    • 6.1.1 Structure
    • 6.1.2 Graphics and layout
  • 6.2 Document dissemination
  • 6.3 Evaluation of the expositive quality (check-list)

Phases of the implementation process

  • 7.1 Implementation and local adaptation
    • 7.1.1 Facilitating factors and impeding factors
    • 7.1.2 Intervention strategies
    • 7.1.3 Professional interventions
  • 7.2 Updating
  • 7.3 Evaluation
    • 7.3.1 Examples of monitoring and evaluation indicators

Brief description of PNLG method for guidelines production

Legal considerations

  • 9.1 General considerations
  • 9.2 Legal value of guidelines in professional liability evaluation

Appendixes

  • A.1 Construction of the multidisciplinary group. Examples of a guideline elaboration process
  • A.2 Grading of recommendations. Examples of different international grading methods
  • A.3 PNLG guidelines database and evaluation of guidelines' methodological quality

References