title: A survey on the methodological processes and policies of renal guideline groups as a first step to harmonize renal guidelines.
abstract: BACKGROUND
  Worldwide, several bodies produce renal guidelines, potentially leading to duplication of effort while other topics may remain uncovered. A collaborative work plan could improve efficiency and impact, but requires a common approved methodology. The aim of this study was to identify organizational and methodological similarities and differences among seven major renal guideline bodies to identify methodological barriers to a collaborative effort.
  
  
  METHODS
  An electronic 62-item survey with questions based on the Institute of Medicine standards for guidelines was completed by representatives of seven major organizations producing renal guidelines: the Canadian Society of Nephrology (CSN), European Renal Best Practice (ERBP), Kidney Disease Improving Global Outcome (KDIGO), Kidney Health Australia-Caring for Australians with Renal Insufficiency (KHA-CARI), Kidney Disease Outcome Quality Initiative (KDOQI), Sociedad Latino-Americano de Nefrologia e Hipertension (SLANH) and United Kingdom Renal Association (UK-RA).
  
  
  RESULTS
  Five of the seven groups conduct systematic searches for evidence, two include detailed critical appraisal and all use the GRADE framework. Five have public review of the guideline draft. Guidelines are updated as new evidence comes up in all, and/or after a specified time frame has passed (N = 3). Commentaries or position statements on guidelines published by other groups are produced by five, with the ADAPTE framework (N = 1) and the AGREEII (N = 2) used by some. Funding is from their parent organizations (N = 5) or directly from industry (N = 2). None allow funders to influence topic selection or guideline content. The budgets to develop a full guideline vary from $2000 to $500 000. Guideline development groups vary in size from <5 (N = 1) to 13-20 persons (N = 3). Three explicitly seek patient perspectives, for example, by involving patients in the scoping process, and four incorporate health economic considerations. All provide training in methodology for guideline development groups and six make their methods public. All try to avoid overlapping topics already planned or published by others. There is no common conflict of interest policy.
  
  
  CONCLUSIONS
  Overall, there is considerable commonality in methods and approaches in renal guideline development by the different organizations, although some procedural differences remain. As the financial and human resource costs of guideline production are high, a collaborative approach is required to maximize impact and develop a sustainable work plan. Coming to consensus on methods and procedures is the first step and appears feasible.
authors.affiliation: Methods Support Team ERBP, Ghent University Hospital, Ghent, Belgium Department for Internal Medicine III, Nephrology and Hypertension Diseases, Transplantation Medicine and Rheumatology, Krankenhaus Elisabethinen, Linz, Austria Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Haller
authors.affiliation: Methods Support Team ERBP, Ghent University Hospital, Ghent, Belgium Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Sabine N
authors.initials: SN
authors.lastname: van der Veer
authors.affiliation: Methods Support Team ERBP, Ghent University Hospital, Ghent, Belgium Renal Division, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Evi V
authors.initials: EV
authors.lastname: Nagler
authors.affiliation: The Richard Bright Kidney Unit, Southmead Hospital, Bristol, UK.
authors.forename: Charlie
authors.initials: C
authors.lastname: Tomson
authors.affiliation: Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lewington
authors.affiliation: Department of Medicine, University of Calgary, Alberta, Canada.
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.affiliation: KHA-CARI, School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Gallagher
authors.affiliation: Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Rocco
authors.affiliation: Universidad Panamericana School of Medicine, Mexico City, Mexico.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Obrador
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Raymond
authors.initials: R
authors.lastname: Vanholder
authors.affiliation: Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia Concord Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.affiliation: Methods Support Team ERBP, Ghent University Hospital, Ghent, Belgium Renal Division, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: van Biesen
mesh_terms: D032921:Consensus; D003625:Data Collection; D019317:Evidence-Based Medicine / Q000331:legislation & jurisprudence* / Q000592:standards*; D006801:Humans; D007674:Kidney Diseases / Q000191:economics / Q000628:therapy*; D009313:National Health Programs / Q000331:legislation & jurisprudence* / Q000458:organization & administration / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*
keywords: evidence-based medicine; practice guidelines as topic