title: The validity of recommendations from clinical guidelines: a survival analysis.
abstract: BACKGROUND
  Clinical guidelines should be updated to maintain their validity. Our aim was to estimate the length of time before recommendations become outdated.
  
  
  METHODS
  We used a retrospective cohort design and included recommendations from clinical guidelines developed in the Spanish National Health System clinical guideline program since 2008. We performed a descriptive analysis of references, recommendations and resources used, and a survival analysis of recommendations using the Kaplan-Meier method.
  
  
  RESULTS
  We included 113 recommendations from 4 clinical guidelines with a median of 4 years since the most recent search (range 3.9-4.4 yr). We retrieved 39 136 references (range 3343-14 787) using an exhaustive literature search, 668 of which were related to the recommendations in our sample. We identified 69 (10.3%) key references, corresponding to 25 (22.1%) recommendations that required updating. Ninety-two percent (95% confidence interval 86.9-97.0) of the recommendations were valid 1 year after their development. This probability decreased at 2 (85.7%), 3 (81.3%) and 4 years (77.8%).
  
  
  CONCLUSIONS
  Recommendations quickly become outdated, with 1 out of 5 recommendations being out of date after 3 years. Waiting more than 3 years to review a guideline is potentially too long.
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont. laura.martinez.garcia@cochrane.es.
authors.forename: Laura
authors.initials: L
authors.lastname: Martínez García
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Andrea Juliana
authors.initials: AJ
authors.lastname: Sanabria
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Elvira
authors.initials: E
authors.lastname: García Alvarez
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Maria Mar
authors.initials: MM
authors.lastname: Trujillo-Martín
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Itziar
authors.initials: I
authors.lastname: Etxeandia-Ikobaltzeta
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Anna
authors.initials: A
authors.lastname: Kotzeva
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: David
authors.initials: D
authors.lastname: Rigau
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Arturo
authors.initials: A
authors.lastname: Louro-González
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Leticia
authors.initials: L
authors.lastname: Barajas-Nava
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Petra
authors.initials: P
authors.lastname: Díaz Del Campo
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Maria-Dolors
authors.initials: MD
authors.lastname: Estrada
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Ivan
authors.initials: I
authors.lastname: Solà
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Javier
authors.initials: J
authors.lastname: Gracia
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Flavia
authors.initials: F
authors.lastname: Salcedo-Fernandez
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lawson
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: R Brian
authors.initials: RB
authors.lastname: Haynes
authors.affiliation: Iberoamerican Cochrane Centre and Biomedical Research Institute Sant Pau (IIB Sant Pau) (Martínez García, Sanabria, Rigau, Barajas-Nava, Solà, Alonso-Coello), Barcelona, Spain; NHS Ayrshire and Arran (García Álvarez), Ayr, United Kingdom; Fundación Canaria de Investigación y Salud (FUNCIS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) (Trujillo-Martín), Tenerife, Spain; Osteba, and Basque Office for Health Technology Assessment (Etxeandia-Ikobaltzeta), Vitoria, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS) (Kotzeva, Estrada), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP) (Kotzeva, Estrada, Solà, Alonso-Coello), Barcelona, Spain; Centro de Saúde de Cambre, Xerencia de Xestión Integrada de A Coruña SERGAS (Louro-González), A Coruña, Spain; Health Technology Assessment Unit (UETS), Subdirección General de Tecnología e Innovación Sanitaria, Consejería de Sanidad (Díaz del Campo), Madrid, Spain; National Clinical Practice Guideline Programme of the NHS (Gracia), Madrid, Spain; GuíaSalud-Aragon Institute of Health Sciences (Salcedo-Fernandez), Zaragoza, Spain; Department of Clinical Epidemiology and Biostatistics, McMaster University, (Lawson, Haynes), Hamilton, Ont.
authors.forename: Pablo
authors.initials: P
authors.lastname: Alonso-Coello
mesh_terms: D015331:Cohort Studies; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013030:Spain; D057170:Translational Research, Biomedical