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Important developments

Two recently published G-I-N papers, the webinars held by G-I-N North America, an update from the adaptation working group and some information about GIRAnet.

Paper on systematic reviews

paper systematic review.jpg

In February 2012 the new journal Systematic Reviews launched its first issue with an article series about the importance of registering systematic reviews using PROSPERO: an international open access prospective register of systematic reviews. G-I-N also recently launched a Data Extraction Resource (GINDER) to present and share data extracted from individual studies in a standardized template.

Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the PROSPERO initiative and we wrote a paper to emphasize the importance of collaboration between guideline developers and systematic reviewers. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

Interaction between guideline developers and systematic reviewers is important for formulating PICO questions, conducting the review of the evidence, compiling the evidence tables and summarizing and presenting the evidence. Collaborative approaches to further improvement of the quality of systematic reviews and the use of high-quality reviews in translating evidence into guideline recommendations are essential.

Van der Wees P, Qaseem A, Kaila M, Ollenschlaeger G, Rosenfeld R, and the Board of Trustees of the Guidelines International Network (G-I-N). Prospective systematic review registration: Perspective from the Guidelines International Network (G-I-N). Systematic Reviews 9 February 2012; 1:3.

G-I-N Board paper in Annals of Internal Medicine

Annals paper.JPGOver the last two decades, there has been an exponential increase in the number of guidelines developed by governmental and private organizations around the world. Clinicians, managers, and other guideline users have been bombarded with numerous and sometimes contradictory guidelines. In addition, there is a major variation in the quality of individual guidelines. Many guidelines fall short of meeting the basic quality criteria or have major inconsistencies in their development methods. Establishment of internationally recognized standards will help improve the development of high quality guidelines as well as their implementation.

In response to the need for international standards to help in the development and appraisal of clinical guidelines, the G-I-N Board of Trustees reviewed the current literature and used a consensus process to propose a set of key components for guideline development. The goal of this paper is to identify the practically implementable standards that a trustworthy clinical practice guideline must meet and proposes minimum principles for the development of high quality guidelines.

We hope that this will help in reducing the number of low quality guidelines and encourage guideline developers to produce high quality guidelines. The intent is to initiate global discussion and consensus regarding minimal standards for guideline development.

Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S, van der Wees P, for the Board of Trustees of the Guidelines International Network. Guidelines International Network: Toward International Standards for Clinical Practice Guidelines. Ann Intern Med. 2012; 156:525-531.

This paper is now open for comments. Please use this link to provide feedback that may help us refining the proposed standards:

G-I-N North America Webinar Series

Since January this year three webinars have been organized by G-I-N North America with the support from Kaiser Permanente. Topics for the first sessions were: “New IOM Standards for Trustworthy Guidelines: Implications for the North American Guideline Community”, "New IOM Standards for Trustworthy Systematic Reviews: Implications for the North American Guideline Community”, "AHRQ and NGC Approach to Addressing the IOM Standards: Implications for the North American Guideline Development Community".

These webinars have been recorded and audio files can be reached via the G-I-N website.

For more information, please visit: This page is regularly updated and contains information on future webinars.

G-I-N adaptation working group, planned activities:

In 2011, G-I-N established the Adaptation Working Group to support the development of methods for efficient guideline development using existing guidelines, to refine the adaptation resource toolkit and to provide support and training in guideline adaptation. The group currently includes 31 individuals from 19 countries, and a smaller steering group was recently formed to help guide the work of this group.

The steering group met for the first time on 9 February 2012 to discuss ideas and suggestions for the group’s work plan in 2012 and beyond. A second meeting is planned for April to finalise the work plan. If you are interested in commenting on our work plan or in joining the Adaptation Working group please contact us through the G-I-N office at

The main areas under consideration for our work plan include:

1. Improvement to guideline adaptation methodologies

  • Dissemination and awareness raising about the ADAPTE manual
  • Translation of the ADAPTE manual into other languages
  • Synthesis of what we have learned about guideline adaptation
  • Improvements to the ADAPTE manual, including the use of GRADE

2. Training and support

People are often looking for support in guideline adaptation. Steering group members and adaptation working group members are likely to have current resources that have been developed individually and sharing them may be a way of facilitating training. Members who have more experience with using the ADAPTE tool could help/mentor those with less experience or could develop educational tools.

3. Communication

The adaptation group needs to improve the way in which it uses the G-I-N website and the enGINe newsletter to communicate with members. To improve external communication, the group is considering disseminating information through member organisations’ newsletters.

G-I-N 2012 in Berlin

The Adaptation group aims to increase its profile at the Berlin conference in August 2012 by offering different opportunities for participants to be involved, including:

  1. A panel discussion session on facilitators and barriers to the use of adaptation methods and ideas for improvement (Abstract submitted)
  2. A face-to-face meeting of the Adaptation Working Group
  3. A survey of G-I-N members and conference participants (under consideration)

We welcome G-I-N members’ feedback on our work plan and encourage you to contact us via the G-I-N office if you are interested in joining this Working Group:

Sue Phillips and Jako Burgers, co-chairs on behalf of G-I-N Adaptation Steering Group

Introducing GIRAnet (jeerah-net):  the Guideline Implementability Research and Application Network

GIRAnet.jpgWith three years of funding from the Canadian Institutes of Health Research we have established the Guideline Implementability Research and Application Network (GIRAnet). The purpose of GIRAnet is to collaborate with international guideline developers, implementers, and researchers to identify or develop, and evaluate implementability tools for guidelines. We have described domains of implementability information which, if added to guidelines, may facilitate their use (See our highly accessed article in Implementation Science).

In year one, we will identify and describe existing tools for priority clinical indications. We are particularly interested in tools representing the following implementability domains: resource implications (equipment, staff, training, workflow); implementation (barriers, tailoring strategies); and evaluation (performance measures, quality improvement). We envision developing a database and instructional manual linking to, or offering indication-specific and generic implementability tools and templates, made available via a dedicated section on the G-I-N website. In years two and three, tools will be pilot tested with guideline developers to understand how they are best integrated in guidelines, and with health professionals for cognitive impact (i.e. meaning, relevance, confidence, outcome expectancy, intention). The tools will ultimately be packaged with guidelines to assess behavioural impact (use of recommendations, associated clinical outcomes).

While GIRAnet’s main goal is to develop and test implementability tools, another year one activity is a formative evaluation to help us optimize goals, activities, communication and engagement, and identify related services or products that could be offered by the network. We are conducting a systematic review of network features that enhance knowledge exchange and will use that as the basis of a needs assessment survey of G-I-N members in the coming months. We are also reorganizing the G-I-N Implementation Community webpage to make retrieval of implementation resources and tools ( more easily assessable.

We are sincerely grateful to G-I-N executive and support staff, and several G-I-N members who form our Steering Committee who have been instrumental in helping us to acquire funding for GIRAnet. Clearly input from all G-I-N members will be essential to the success of GIRAnet, ensuring that its products are relevant. Therefore over the coming months we will seek participants for evaluation activities, and continue to provide you with progress updates.

See you in Berlin for G-I-N 2012!

For more information about GIRAnet please visit the G-I-N web site: For specific enquiries please contact the GIRAnet lead:  Anna Gagliardi, Associate Professor, University of Toronto and Affiliate Scientist, University Health Network, Toronto, Canada,

Page last updated: Feb 18, 2014
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