AAN Guideline Development Process

The Quality Standards Subcommittee (QSS) and the Therapeutics and Technology Assessment Subcommittee (TTA) each follow a well-established process for the development of an evidence-based guideline. The process is designed to rigorously evaluate the strength of the literature and formulate explicit recommendations to improve patient outcomes. Each practice guideline is the culmination of the generous donation of time, energy, and expertise of topic experts and methodology experts.

Full Process

Access the complete 2004 AAN Guideline Process Manual.

Process Summary

The following eight stages make up the AAN Guideline Development Process:

Select Guideline Topics
Form Expert Author Panel
Develop Clinical Questions
Review the Literature
Write the Guideline
Extensive Peer Review
AAN Approval
Update Statements

Select Guideline Topics

AAN members, committees, and sections are encouraged to submit guideline topic nominations. QSS and TTA review nominated topics based on the following criteria:

AAN members' needs
Prevalence of condition
Health impact of condition for the individual and others
Socioeconomic impact
Extent of practice variation
Quality of available evidence
External constraints on practice
Urgency for evaluation of new practice technology

Form Expert Author Panel

Once a guideline topic is selected, QSS and TTA select a lead author and form a balanced author panel. All AAN members are encouraged to sign up to serve as a guideline author.*

Develop Clinical Questions

Each guideline should address one or more specific, answerable clinical questions. A clinical question should have the following three basic components:

The type of patient
The type of exposure that the patient experiences (risk factor, intervention, diagnostic test)
The outcomes to be addressed

Review the Literature

The author panel critically assesses the topic through analysis of the medical literature. MEDLINE, EMBASE, and other pertinent databases are searched. Panel members review the identified articles based upon a priori inclusion and exclusion criteria and pertinence to the topic. Selected articles are rated based on quality of study design, and clinical practice recommendations are developed and stratified to reflect the quality and the content of the evidence.

Write the Guideline

Data is abstracted and formulated into a draft guideline with specific recommendations. The guideline should include the following: ·

An introduction that outlines the clinical question being addressed
A methods section that describes the literature review
A brief analysis of all of the pertinent articles identified in the literature search
A summary of the evidence in answer to the clinical question
Practice recommendations linked directly to the evidence
Future research recommendations highlighting gaps and inadequacies in the current literature base

Extensive Peer Review

Draft guidelines are reviewed for accuracy, quality, and thoroughness by AAN members, topic experts, and pertinent physician organizations. AAN members are encouraged to sign up to review draft guidelines.

AAN Approval

Before being published as an AAN practice guideline, the manuscript must receive approval from its sponsoring subcommittee (QSS or TTA), the AAN Practice Committee, and the AAN Board of Directors.

Update Statements

Guidelines are updated or affirmed every three years or earlier, based upon the availability of new evidence.

* All AAN guideline authors are required to complete the AAN Guideline Author Conflict of Interest Reporting Form. QSS and TTA review the completed forms and manage conflicts of interest through balancing the panel, limiting?and potentially preventing?participation, and by providing strong oversight. In addition, the following paragraph is included on every AAN guideline.

The American Academy of Neurology is committed to producing independent, critical, and truthful clinical practice guidelines (CPGs). Significant efforts are made to minimize the potential for conflicts of interest to influence the recommendations of this CPG. To the extent possible, the AAN keeps separate those who have a financial stake in the success or failure of the products appraised in the CPGs and the developers of the guidelines. Conflict of interest forms were obtained from all authors and reviewed by an oversight committee prior to project initiation. AAN limits the participation of authors with substantial conflicts of interest. The AAN forbids commercial participation in, or funding of, guideline projects. Drafts of the guideline have been reviewed by at least three AAN committees, a network of neurologists, Neurology peer reviewers, and representatives from related fields.

Read the complete AAN COI policy. Detailed analysis of COI management is published and available.

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Practice Practice Guidelines Patient Safety Quality Initiatives Pay-for-Performance Public & Private Insurer Relations Coding & Reimbursement Running a Practice Health Information Technology About This Section	AAN Guideline Development Process The Quality Standards Subcommittee (QSS) and the Therapeutics and Technology Assessment Subcommittee (TTA) each follow a well-established process for the development of an evidence-based guideline. The process is designed to rigorously evaluate the strength of the literature and formulate explicit recommendations to improve patient outcomes. Each practice guideline is the culmination of the generous donation of time, energy, and expertise of topic experts and methodology experts. Full Process Access the complete 2004 AAN Guideline Process Manual. Process Summary The following eight stages make up the AAN Guideline Development Process: Select Guideline Topics Form Expert Author Panel Develop Clinical Questions Review the Literature Write the Guideline Extensive Peer Review AAN Approval Update Statements Select Guideline Topics AAN members, committees, and sections are encouraged to submit guideline topic nominations. QSS and TTA review nominated topics based on the following criteria: AAN members' needs Prevalence of condition Health impact of condition for the individual and others Socioeconomic impact Extent of practice variation Quality of available evidence External constraints on practice Urgency for evaluation of new practice technology Form Expert Author Panel Once a guideline topic is selected, QSS and TTA select a lead author and form a balanced author panel. All AAN members are encouraged to sign up to serve as a guideline author.* Develop Clinical Questions Each guideline should address one or more specific, answerable clinical questions. A clinical question should have the following three basic components: The type of patient The type of exposure that the patient experiences (risk factor, intervention, diagnostic test) The outcomes to be addressed Review the Literature The author panel critically assesses the topic through analysis of the medical literature. MEDLINE, EMBASE, and other pertinent databases are searched. Panel members review the identified articles based upon a priori inclusion and exclusion criteria and pertinence to the topic. Selected articles are rated based on quality of study design, and clinical practice recommendations are developed and stratified to reflect the quality and the content of the evidence. Write the Guideline Data is abstracted and formulated into a draft guideline with specific recommendations. The guideline should include the following: · An introduction that outlines the clinical question being addressed A methods section that describes the literature review A brief analysis of all of the pertinent articles identified in the literature search A summary of the evidence in answer to the clinical question Practice recommendations linked directly to the evidence Future research recommendations highlighting gaps and inadequacies in the current literature base Extensive Peer Review Draft guidelines are reviewed for accuracy, quality, and thoroughness by AAN members, topic experts, and pertinent physician organizations. AAN members are encouraged to sign up to review draft guidelines. AAN Approval Before being published as an AAN practice guideline, the manuscript must receive approval from its sponsoring subcommittee (QSS or TTA), the AAN Practice Committee, and the AAN Board of Directors. Update Statements Guidelines are updated or affirmed every three years or earlier, based upon the availability of new evidence. * All AAN guideline authors are required to complete the AAN Guideline Author Conflict of Interest Reporting Form. QSS and TTA review the completed forms and manage conflicts of interest through balancing the panel, limiting?and potentially preventing?participation, and by providing strong oversight. In addition, the following paragraph is included on every AAN guideline. The American Academy of Neurology is committed to producing independent, critical, and truthful clinical practice guidelines (CPGs). Significant efforts are made to minimize the potential for conflicts of interest to influence the recommendations of this CPG. To the extent possible, the AAN keeps separate those who have a financial stake in the success or failure of the products appraised in the CPGs and the developers of the guidelines. Conflict of interest forms were obtained from all authors and reviewed by an oversight committee prior to project initiation. AAN limits the participation of authors with substantial conflicts of interest. The AAN forbids commercial participation in, or funding of, guideline projects. Drafts of the guideline have been reviewed by at least three AAN committees, a network of neurologists, Neurology peer reviewers, and representatives from related fields. Read the complete AAN COI policy. Detailed analysis of COI management is published and available. For More Information Thomas Getchius Senior Manager, Clinical Practice tgetchius@aan.com (651) 695-2805	Advertisement Advertisement

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