title: Simultaneous development of guidelines and quality indicators -- how do guideline groups act? A worldwide survey.
abstract: OBJECTIVE
  The purpose of this paper is to examine the question of how official bodies, health care organisations, and professional associations deal with the absence of a methodological gold standard for the simultaneous development of clinical practice guidelines and quality indicators, what procedures they use and what they feel are major strengths and limitations of their methods.
  
  
  METHODS
  The authors conducted a web-based survey among 90 organisational members of the Guidelines International Network (G-I-N) representing 34 countries from Africa, America, Asia, Europe and Oceania. All organisational G-I-N members were invited to participate in the survey by following a link provided in the invitation e-mail.
  
  
  RESULTS
  The responses of 24 organisations were included in the final analysis. The results indicate a broad variability in the approaches and methods used to develop quality indicators and guidelines simultaneously. The answers of the participants indicated a lack of formal procedures for the simultaneous development. Formal procedures exist in only about half of the participating organisations. In addition, piloting or evaluation of the procedures is almost completely missing. Significantly, respondents mainly reported that the procedure used in their organisation "could certainly be more rigorous". Besides various strengths, participants reported a considerable number of limitations of the development processes they use.
  
  
  CONCLUSIONS
  This survey among G-I-N members -- despite limitations -- gives helpful insights in the state of the simultaneous development of quality indicators and clinical practice guidelines and underlines the need for future activities in methodological standard development and quality improvement of these processes.
authors.affiliation: University Medical Center Hamburg-Eppendorf Hamburg, Germany. e.blozik@uke.de
authors.forename: Eva
authors.initials: E
authors.lastname: Blozik
authors.forename: Monika
authors.initials: M
authors.lastname: Nothacker
authors.forename: Thomas
authors.initials: T
authors.lastname: Bunk
authors.forename: Joachim
authors.initials: J
authors.lastname: Szecsenyi
authors.forename: Günter
authors.initials: G
authors.lastname: Ollenschläger
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
mesh_terms: D003625:Data Collection; D019317:Evidence-Based Medicine / Q000592:standards*; D014943:Global Health; D006801:Humans; D020407:Internet; D017410:Practice Guidelines as Topic / Q000592:standards*; D016730:Program Development / Q000379:methods / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000592:standards*