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Important developments

Information about the panel session prepared by the adaptation steering group, feedback on the survey related to the Annals paper, update from G-I-N North America and its webinar and conference at the end of the year, and an update on GIRAnet.

Methods and Models of Guideline Adaptation – G-I-N 2012, Berlin

If you are interested in guideline adaptation, the Adaptation Working Group is offering a number of opportunities to connect, learn, and share at G-I-N 2012. Foremost among these is a panel discussion session featuring members from Argentina, Australia, Brazil, Canada, and Germany, who will showcase their experiences in adapting guidelines, particularly the methods used and the barriers and facilitators associated with the adaptation processes.

The panellists will discuss various cultural and professional issues as well as other aspects such as the preconditions for guideline adaptation (e.g. time, expertise, and resources), the challenge of engaging stakeholders, and the problem of competing interests. Experience with grading systems will be explored by comparing and contrasting case studies of two different systems that were used within an ADAPTE framework to grade the level of evidence and the strength of recommendations. The issues related to expanding adaptation processes to encompass methodologies for updating adapted guidelines will also be presented.

Toward the end of the session, Jako Burgers and Sue Phillips, co-Chairs of the Adaptation Steering Group, will provide expert commentary on the commonalities and differences among the examples presented by the panellists to draw out issues that may be unique to developed or developing countries, and to devise a “cheat sheet” of what works and what doesn’t in guideline adaptation. This will provide the starting point for a brainstorming session in which the audience can join panel members in discussing ways to improve existing guideline adaptation methods.

If you wish to learn more about the Adaptation Working Group or you are interested in joining the Group, come along to our panel session or meeting at G-I-N 2012 or contact us via the G-I-N office:

Discussion on the G-I-N Paper on “Toward International Standards for Clinical Practice Guidelines”

Annals paper.JPG

G-I-N is celebrating its 10th anniversary in 2012 and one of the major accomplishments this year has been the publication of the paper, “Toward International Standards for Clinical Practice Guidelines” in Annals of Internal Medicine. The goal of this paper was to propose a set of key standards for guideline development and to promote discussion and eventual agreement on a set of international standards for guideline development. The need for this paper is obvious. The number of guidelines developed by governmental and private organizations worldwide has increased. However, the variability in the quality between these guidelines is staggering and guideline users such as clinicians, patients, and other stakeholders struggle with this issue. The proposed key components presented in this article should help guideline developers to improve the quality of their guidelines by incorporating these standards into their guideline development processes. These standards should also assist users in assessing the strengths and weaknesses of a guideline.

Since the publication of this paper, we conducted a survey of G-I-N members to find out their opinion of these standards and to initiate a discussion. An overwhelming majority of the respondents agreed with the suggested standards. The results of this survey will be presented at a plenary session on August 24, 2012 at 9:00am to 10:30am during G-I-N’s 2012 10th annual meeting in Berlin, Germany.

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.

Amir Qaseem, MD, PhD, MHA, FACP

G-I-N North America

Overview of Activities

The 2011-2012 year has been an extremely busy one for G-I-N North America (GIN-NA), with intense activity focused on two projects (described below): a monthly webinar series, co-sponsored with Kaiser Permanente in California, and an upcoming major guideline conference, co-sponsored with the New York Academy of Medicine (NYAM). The NYAM conference facility in Manhattan can accommodate up to 500 attendees, and based on initial interest we should fill most of the space. We have a commitment from Susan Dentzer, editor in chief of Health Affairs, to publish a series of conference-related manuscripts. Last, we have developed a GIN-NA email distribution list with over 700 entries and are in the process of refining the list based on outreach to assess interest.

G-I-N North America Webinar Series

Starting in January 2012 we began a monthly webinar, which has kindly been hosted by Gladys Tom and Marguerite Koster on a WebEx platform through Kaiser Permanente. Webinars include a 30-45 minute slide presentation followed by a moderated question and answer session, and are available through the G-I-N website. The following webinars have been held (or planned):

  1. January 2012. New IOM standards for guidelines: implications for the North American Guideline Community. Rick Shiffman (speaker), Rich Rosenfeld (moderator).
  2. February 2012. New IOM standards for systematic reviews: implications for the North American Guideline Community. Chris Schmid (speaker), Rich Rosenfeld (moderator)
  3. March 2012. AHRQ and NGC approach to addressing the IOM standards. Vivian Coates (speaker), Jean Slutsky (speaker), Rich Rosenfeld (moderator)
  4. April 2012. Best practices for managing conflict of interest in guideline development. Sandra Zelman Lewis (speaker), Gordon Guyatt (speaker), Rich Rosenfeld (moderator)
  5. June 2012. New technologies to facilitate clinical practice guideline development. Thomas Getchius (speaker), Gary Gronseth (speaker), Wiley Chan (speaker), Marguerite Koster (moderator)
  6. July 2012. Rapid review methodology. David Moher (speaker), Marguerite Koster (moderator)
  7. September 2012. G-I-N standards for trustworthy guidelines: differences and similarities with IOM standards. Amir Qaseem (speaker), Marguerite Koster (moderator)

Evidence-Based Guidelines Affecting Policy, Practice and Stakeholders (E-GAPPS)

G-I-N NYAM.JPGG-I-N North America will co-sponsor with the New York Academy of Medicine (NYAM) a two-day conference on “Evidence-based Guidelines Affecting Policy, Practice and Stakeholders”.  The event will take place on December 10th and 11th, 2012 at the NYAM, located in Manhattan at Fifth Avenue and 103rd Street. The conference, co-chaired by Peter Wyer and Richard Rosenfeld, is crafted around the following key plenary themes:

  • From bench to trench: how evidence and guidelines shape health care policy
  • What makes a clinical practice guideline trustworthy?
  • Minding the message: the senders, givers, and users of guideline information
  • Making it happen: adapting, implementing, and tracking.

Confirmed plenary speakers include Mary Barton (NCQA), Sharon Begley (Reuters), Otis Brawley (American Cancer Society), Carolyn Clancy (AHRQ), Patrick Conway (CMS), Dave Davis (AAMC), Kay Dickersin (US Cochrane Center), David Eddy (Archimedes, Inc.), Ian Graham (CIHR), Gordon Guyatt (McMaster University), Blackford Middleton (Partners Healthcare System), Susan Pingleton (University of Kansas), Sandy Schwartz (Wharton), Nirav Shah (NY State DOH), and Albert Siu (Mount Sinai).  The conference will also feature 12 interactive breakout sessions moderated by Michael Cantor (NYU), Louis Jacques (CMS), Marguerite Koster (Kaiser Permanente), Eddy Lang (Alberta Health Services), Richard Rosenfeld (AAO-HNS), Holger Schunemann (McMaster University), Rebecca Burkholder (National Consumers League), Amir Qaseem (ACP), and others.

To register for the E-GAPPS conference please visit:

Steering Group for G-I-N North America

Richard M. Rosenfeld, MD, MPH, Chair (US)

Rebecca Burkholder, JD (US)

Dave Davis, MD, CCFP, FCFP (US)

Kay Dickersin, PhD (US)

Marguerite Koster, MA, MFT (US)

Sandra Zelman Lewis, PhD (US)

Sam E.D. Shortt, MD, PhD, FCFP (CA)

Holger Schünemann, MD, MSc, PhD (CA)

Richard N. Shiffman, MD, MCIS (US)

Philip van der Wees, PhD, PT (The Netherlands)

Peter Wyer, MD (US)


Guideline Implementability Research and Application Network (GIRAnet)


GIRAnet is a collaboration of international guideline developers, implementers, and researchers that seek to integrate guideline implementation with guideline development. We will identify and describe existing implementability tools, and develop and evaluate new tools. While there are many types, we are interested in implementability tools that support guideline resource planning, implementation and evaluation.

Canadian guideline implementability meeting

On April 27th 2012, GIRAnet met with 42 Canadian guideline developers, implementers, and researchers who provided guidance on how to identify and describe implementability tools, which will shape our ongoing activities. A summary report is available on the G-I-N web site.

Identification of implementability tools

We reviewed 100 guidelines on prevalent clinical indications to identify and describe embedded or accompanying implementability tools for resource planning, implementation and evaluation. We are now

searching for generic tools in these domains. A repository will be created on the web site that links to the identified tools, and to which others can contribute. We will also establish criteria and methods for developing implementability tools.

We need your help!

Please help us to define and identify additional implementability tools by completing a brief survey. Please completed by August 2012.

Join the GIRAnet Interest Group!

GIRAnet activities and products are shaped by input from those interested in improving the implementation of clinical guidelines. We may ask for member’s assistance in identifying or reviewing implementability tools, participating in an interview or survey, or helping identify health professionals that may evaluate new implementability tools. You will also receive our quarterly newsletter which will update you on our many projects. Please let us know if you’d like to join!

We look forward to hearing from you and seeing you in Berlin for G-I-N 2012!

For more information about GIRAnet please visit the GIRAnet webpage.

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: Jul 03, 2012
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