title: Developing clinical guidelines  for end-of-life care:  blending evidence and consensus.
abstract: BACKGROUND
  Developing clinical practice guidelines (CPGs) is challenging, particularly in areas that are difficult to research such as end-of-life care.
  
  
  OBJECTIVE
  To describe the process that staff in a large regional health-care service in Victoria, Australia, used to develop CPGs for managing diabetes at the end of life.
  
  
  METHODS
  An interdisciplinary advisory group was appointed, a structured literature review undertaken, personal illness accounts sourced, and a guiding philosophy formulated. Individual interviews were conducted with people with diabetes and their carers. Formative and summative evaluation was undertaken.
  
  
  RESULTS
  No level I or II evidence was identified. The interviews yielded important information about how people wanted their diabetes managed. Formative evaluation enabled stakeholders to participate in developing the CPGs. The summative evaluation confirmed the CPGs are easy to use and appropriate to clinical staff.
  
  
  CONCLUSIONS
  The CPG development process yielded the best current evidence on which to base care plans and person-centred CPGs.
authors.affiliation: Barwon Health and Deakin University, Kitchener House, The Geelong, Victoria, Australia. trisha.dunning@barwonhealth.org.au
authors.forename: Trisha
authors.initials: T
authors.lastname: Dunning
authors.forename: Sally
authors.initials: S
authors.lastname: Savage
authors.forename: Nicole
authors.initials: N
authors.lastname: Duggan
authors.forename: Peter
authors.initials: P
authors.lastname: Martin
mesh_terms: D001315:Australia; D032921:Consensus; D003920:Diabetes Mellitus / Q000451:nursing*; D019468:Disease Management; D019317:Evidence-Based Medicine; D006801:Humans; D018802:Patient-Centered Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards*; D017410:Practice Guidelines as Topic; D016730:Program Development; D013727:Terminal Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards*; D014739:Victoria