Please consider attending this webinar hosted by the Guidelines International Network (G-I-N) North America chapter. G-I-N North America is a network for North American guideline users, developers, and other stakeholders to form partnerships and discuss regional guideline issues.

Topic: How to Work with AHRQ to Identify and Develop Topics for Systematic Reviews:  Opportunities for the North American Guideline Community
Date: Tuesday, March 26, 2013
Time: 12:00 p.m.–1:30 p.m. PT / 3:00 p.m.–4:30 p.m. ET
Access:  WebEx (information below)

G-I-N North America invites you to the next presentation in its webinar series on working with the Agency for Healthcare Research & Quality (AHRQ) to identify and develop topics for systematic reviews. Under its Effective Health Care (EHC) Program, AHRQ supports 11 Evidence-based Practice Centers (EPCs) to conduct systematic reviews of the evidence. This presentation outlines how clinical practice guideline developers can work with AHRQ to identify and develop topics for AHRQ-funded systematic reviews, which can then be used to inform the development of clinical practice guidelines.

Presenter:
Supriya Janakiraman, MD, MPH
Center for Outcomes and Evidence
Agency for Healthcare Research & Quality (AHRQ)
Washington, DC

Supriya Janakiraman, MD, MPH, is a graduate of the Albert Einstein College of Medicine (MD), the Johns Hopkins Bloomberg School of Public Health (MPH), and Columbia University (BA). She is board-certified in internal medicine and general preventive medicine. As a medical officer for the Center for Outcomes and Evidence, she is primarily involved in the Evidence-based Practice Center Program and oversees the Effective Health Care Program's Topic Selection process. Prior to joining AHRQ, Dr. Janakiraman was a practicing primary care physician in California.

Moderator:
Marguerite Koster, MA, MFT
Chair-Elect, G-I-N North America Steering Group
Practice Leader, Technology Assessment & Guidelines Unit
Kaiser Permanente Southern California

Learning Objectives
The objectives of this webinar are for participants to:
1. Understand AHRQ’s Effective Health Care Program and Evidence-based Practice Center Program which produce systematic reviews of the evidence.
2. Learn how guideline developers can work with AHRQ to nominate topics for AHRQ systematic reviews, which can then be used to inform upcoming guidelines.
3. Identify opportunities for guideline developers to work with AHRQ and its investigators in the development of a systematic review.

Please feel free to share this information with others who may be involved in clinical practice guideline development, adaptation, implementation, and performance measurement in North America.  

WebEx information
Topic: G-I-N NA Monthly Webinar
Date: Tuesday, March 26, 2013
Time: 12:00 p.m. PT
Meeting Number: 577 350 039
Meeting Password: 26March2013

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If you didn’t make it to the E-GAAPS conference, you missed a great opportunity for networking, sharing ideas, and improving your knowledge of guideline development, the importance of shared decision making, and many more topics. Below are a few highlights from this conference from our guideline committee chair, methodologist, and staff.

From our Guideline Committee Chair: I was in awe!

“This was the first guideline conference I attended and I was in awe of the talent and progression of societies in guideline development. I particularly was intrigued by the medical informatics and technology talks and will be discussing how to make our guidelines more compatible with clinical decision support. The energy and thoughtfulness of guideline developers within private health care systems was an inspiration along these lines. I see this as a logical approach to track adherence to our guideline recommendations.” 

From our Methodologist: Continual improvements to the GRADE tools and methodology.

“We’ve updated our process manual to be consistent with the IOM standards for guidelines and systematic reviews and modified the GRADE methodology for our evidence synthesis process. I was pleased to see that working groups are developing easy-to-use tools to make the process of GRADE more transparent. We also got some great ideas regarding performing pragmatic systematic reviews.”

From our Staff: Networking!

It’s great to see so many familiar faces at this conference and to make new acquaintances. I enjoyed conversations about AAN’s grant work in process, projects that are just about to publish, changes to development and dissemination methodologies, and new technologies on the horizon to aid in guideline development.” 

Finally, congratulations to the conference organizers and the planning committee. This first conference was a success and something I hope that will continue in future years. And thanks very much to New York Academy of Medicine for making their facility available; it was a spectacular venue. 

If you attended the conference, please share your key takeaways with our readers. And plan now to attend the 10^th Annual Guidelines International Conference in San Francisco in August. Bring your staff, your committee members, and your methodologists. We look forward to seeing you in there, if not sooner. 

I recently spoke with Richard M. Rosenfeld, MD, MPH, conference co-chair, chair of Guidelines International Network North America (G-I-N NA), and a G-I-N trustee, regarding the upcoming Evidence-Based Guidelines Affecting Policy, Practice and Stakeholders (E-GAAPS) conference in New York City on December 10–11, 2012.

TG: What prompted G-I-N NA to host this conference?

RR: We created this conference for the same reason G-I-N NA was formed: to help fulfill a pressing need for networking, communication, and exchange of best ideas and practices among individuals and organizations that develop, adapt, disseminate, and implement clinical practice guidelines.

TG: I notice there is a number of high-profile speakers and faculty for this two-day conference. How were these individuals selected?

RR: We began by forming a program committee representing the conference sponsors (G-I-N North America and the New York Academy of Medicine) and then added key individuals to represent additional stakeholders. We set the bar high and sought to identify and engage the best and brightest individuals in the field. The resulting speaker roster is literally a “who’s who” of luminaries in guidelines and related disciplines (e.g., media, communications, health policy, etc.).

TG: Who should attend this conference?

RR: Quite simply anyone who uses, adapts, develops, disseminates, or implements guidelines can benefit from the plenary sessions and numerous workshops. This includes not only clinicians, but also students, the public, consumers, the media, administrators, health policy makers, and staff from professional medical associations.

TG: Will there be opportunities for guideline developers to network or present information about their development and dissemination practices?

RR: Yes, we have set aside space for networking throughout the program. A primary objective of the G-I-N is to promote communication and networking, and this them is reflected the conference.

TG: What are G-I-N NA’s measures of success for this course?

RR: First, we would like to see spirited participation and exchange of ideas in the numerous workshop and breakout sessions that are a highlight of the program. Second, we would like to see increased interest and participation in G-I-N NA and the parent organization, G-I-N, to ensure that future events, webinars, and conferences best fulfill the needs of the North American guideline community. 

I hope to see you at the E-GAAPS conference on December 10–11 in New York City. Visit www.nyam.org/events/2012/evidence-based-guidelines-conference.html for more information on the meeting and registration.

G-I-N (Guidelines International Network) North America invites asks you to mark your calendar for Tuesday, June 26, 2012, for the next presentation in the G-I-N North America webinar series.  Thomas Getchius and Gary Gronseth, MD, FAAN, from the American Academy of Neurology, and Wiley Chan, MD, from Kaiser Permanente will be demonstrating examples of how technology can be used to facilitate the development of systematic reviews and clinical practice guidelines following 2011 Institute of Medicine (IOM) standards.

Please see below for more detailed information regarding this webinar. We hope you will attend!

Presenters:
Thomas Getchius, BA
Associate Director, Clinical Practice
American Academy of Neurology
Minneapolis, MN

Gary Gronseth, MD, FAAN
Professor of Neurology, University of Kansas
Kansas City, KS
Evidence-based Medicine Methodologist,
American Academy of Neurology
Minneapolis, MN

Wiley Chan, MD
Director, Guidelines & Evidence-based Medicine
Physician, Internal Medicine
NW Permanente
Portland, OR

Moderator:
Marguerite Koster, MA, MFT
Steering Group Chair, G-I-N North America
Practice Leader, Southern California Permanente Medical Group
Technology Assessment and Guidelines Unit

Learning Objectives
At the end of the call, attendees will:
1. Receive information about the American Academy of Neurology and Kaiser Permanente processes for developing systematic reviews (SRs) and clinical practice guidelines (CPGs)
2. Understand how the American Academy of Neurology and Kaiser Permanente uses various types of technology to strive to develop IOM compliant SRs and CPGs

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WEBEX Information

Topic: GIN NA JUNE WEBINAR
Date: Tuesday, June 26, 2012
Time: 1:00 p.m., Pacific Daylight Time (San Francisco, GMT-07:00)
Meeting Number: 579 448 234
Meeting Password: GINNAJUNE26


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Our friends at the Guidelines International Network (G-I-N) ask that you make sure you mark your calendar for the North American Webinar Series event on March 29. The topic this month features speakers from the Agency for Healthcare, Research, and Quality (AHRQ) and the National Guidelines Clearinghouse (NGC). These two speakers will address their organizations’ approaches to addressing the Institute of Medicine (IOM) Standards and their implications for the North American Guideline Development Community. They will discuss their phased approach to the IOM Standards for Trustworthy Guidelines. They also are interested in feedback from members of the North American guideline community on how best to meet their needs as end users of the NGC. Please see the rest of the webinar information below. We hope you will attend!

Date: Thursday, March 29, 2012
Time: 1:00 p.m. - 2:30 p.m. (Pacific); 2:00 p.m.-3:30 p.m. (Mountain); 3:00 p.m.-4:30 p.m. (Central); 4:00 p.m.-5:30 p.m. (Eastern)

Access: Information below

Presenters:
Vivian H. Coates, MBA
Project Director, National Guideline Clearinghouse/National Quality Measures Clearinghouse
Vice President, ECRI Institute
Plymouth Meeting, PA

Jean Slutsky
Director, Center for Outcomes and Evidence
Agency for Healthcare Research and Quality
Rockville, MD

Moderator:
Richard M. Rosenfeld, MD, MPH
Steering Group Chair, G-I-N North America
Professor and Chairman of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY

Learning Objectives
At the end of the call, the attendees will gain:

1. Understanding of the IOM's sugestions for AHRQ and NGC regarding Standards for Trustworthy Guidelines
2. Familiarity with NGC's current process for gathering guideline documentation that might meet the IOM standards
3. Insight into the challenges associated with documenting adherence to the IOM standards
4. Knowledge of the phased approach AHRQ and NGC are taking to address the IOM standards
5. Understanding of specific challenges guideline developers anticipate in adopting the IOM standards

I had the opportunity to talk with Sandy this week about the American College of Chest Physicians’s (ACCP) first-ever guideline methodology workshop, titled “Aim to Reach the Institute of Medicine Standards for Trustworthy Guidelines.”

TG: It’s a pleasure to be speaking with you about this today, Sandy.

SZL: Thank you, Tom. It is my pleasure to participate with you on the new AAN Guidelines Blog. Thank you for inviting me!

TG: What prompted ACCP to host this course?

SZL: We offered a similar course, although only for one day, just before the Guidelines International Network (G-I-N) conference in Chicago in 2010. We were thrilled that 98 people attended. Many conference attendees who did not attend our course heard about it from others who did. Several asked me if we were planning to repeat the course. After the IOM [Institute of Medicine] reports were published last year, there was considerable discussion, especially at the IOM-sponsored Next Steps Workshop, about the need for educational programs to improve the quality of guideline methodology. Because of the great interest, we are offering the course again in a two-day format.

TG: I noticed there’s a good mix of faculty for this two-day course. Are these individuals past ACCP guideline authors, or are they professionals who bring additional expertise?

SZL: The course will be taught by both ACCP professional staff and individuals who have participated in writing ACCP guidelines in the past. Two of our own methodologists will be teaching how to develop comprehensive and systematic reviews, meta-analyses, and evidence tables and profiles.

We also have leadership from our Health and Science Policy Committee (our guidelines oversight committee) who have up to 8 years of experience in this field. They will be teaching the sections on conflicts of interest, panel composition, guideline reviews and appraisals, maintaining currency, dissemination, implementation, and quality improvement.

One of our faculty members is a physician methodologist with experience on our two largest guidelines (antithrombotic therapies and lung cancer), as well as having served as a resource consultant on the cost-effectiveness considerations. He will teach incorporating patient values and preferences, as well as resource considerations.

Finally, I am chairing the course and guiding the curriculum, based on over 12 years of experience in this field. I will cover the IOM standards; the PICO [population, intervention of interest, comparator, outcome] process for standardizing the research and guideline method; and the manuscript and recommendations writing, grading, and voting; as well as some challenges like dissenting voices.

TG: How do the IOM standards change the way that ACCP will develop guidelines?

SZL: This is an excellent time for all guideline developers to reassess their strengths and areas in which they can improve. Although we, like AAN, pride ourselves on our rigorous guideline development processes, there is always room for enhancements. The National Guideline Clearinghouse review in September revealed that there are no guidelines that meet all of the IOM standards.

The main areas in which the ACCP is planning for improvement is increasing inclusivity on our panels by adding [evidence-based medicine]-trained consumer representatives (note that I did not say patient advocates) and incorporating external feedback earlier in the process.

TG: What are ACCP’s measures of success for this course?

SZL: Like the previous course, we are planning a two-pronged approach for evaluation. We identified learning objectives and included them in all of the promotional materials and communications about this course. This will help potential registrants make judgments about the value of the course relative to their needs. We are providing up to 16 hours of CME [continuing medical education credit] so we have a standard online evaluation that they take to get their CME credits. In addition, we also are engaging in a Commit To Change evaluation, which prompts our attendees to revisit 6 months later what they have learned in the course and what they identified as realistic and measurable changes that they could implement in their own guideline work.

TG: What advice does ACCP have for societies embarking on guideline development?

SZL: This is not an easy environment for novice guideline developers. The IOM standards set the bar quite high, and I believe there will be some form of accounting for whether these standards are met, or not, in the near future. The details, of course, are yet to be made clear, and certainly that lack of specificity is problematic.

However, courses like this one are aimed to provide a standardized methodology with quite a bit of hands-on learning. We will also provide the framework and some tools and resources that will give developers a good start. In addition, organizations like the G-I-N and the Agency for Healthcare Research and Quality (AHRQ) are very valuable for professional education and skills development. In this part of the world, we are fortunate to be able to participate in the G-I-N North America Interest Group, which will be hosting a joint conference with the New York Academy of Medicine in December. This will be an excellent opportunity for guideline developers of all levels of experience to learn and share from each other. I have found that guideline developers love networking, and that is a great way for both novice and more-experienced developers to continue to learn and improve.

In fact, Tom, networking with other guideline developers is how you and I met. It has been a pleasure for me to learn more about how the AAN guideline process works. And thank you, again, for this opportunity to contribute to the AAN Guidelines Blog.

I hope you’ll attend ACCP’s methodology summit on March 15–16, 2012, in Chicago, IL. Check out http://www.chestnet.org/accp/events/accp-guidelines-methodology-course
for registration- and meeting-related information.