title: Priority-based initiative for updating existing evidence-based clinical practice guidelines: the results of two iterations.
abstract: OBJECTIVE
  New evidence continues to emerge and requires attention after the release of a clinical practice guideline (CPG). The objective of this article is to describe the Document Assessment and Review (DAR) strategy designed to ensue that the CPGs remain current and their quality maintained and to present the results of two iteration of its implementation.
  
  
  METHODS
  The DAR process involves an annual assessment of our CPGs and a review of documents that require an update search. Two questionnaires are used to conduct the annual assessment and the review. The review involves evidence search, evidence review, and review approval.
  
  
  RESULTS
  In 2011, 109 documents were assessed; 22 (20%) were archived, 1 (1%) was deferred for assessment in 2012, 24 (22%) were considered special cases and 62 (57%) needed a new systematic review of the evidence. Of those 62, 19 (31%) were categorized as urgent, 16 (26%) as high, and others as medium or low priority. In 2012, 88 total documents were assessed; 15 (17%) were archived, 32 (36%) deferred, 3 (3%) were considered special cases, and 38 (43%) were prioritized for review.
  
  
  CONCLUSIONS
  Assessment and prioritization of existing CPGs are effective ways of ensuring that resources are directed toward the upkeep of those that are relevant and of highest priority.
authors.affiliation: Department of Oncology, McMaster University, 1280 Main Street West Hamilton, Ontario L8S4L8, Canada; Escarpment Cancer Research Institute (ECRI), Juravinski Hospital Research Centre, 711 Concession Street, G Wing, Hamilton, Ontario, L8V 1C3, Canada; Program in Evidence-based Care, Cancer Care Ontario McMaster University, Juravinski Site, 60 (G) Wing, 711 Concession Street Hamilton, Ontario, Canada, L8V 1C3.
authors.forename: Chika
authors.initials: C
authors.lastname: Agbassi
authors.affiliation: Department of Oncology, McMaster University, 1280 Main Street West Hamilton, Ontario L8S4L8, Canada; Escarpment Cancer Research Institute (ECRI), Juravinski Hospital Research Centre, 711 Concession Street, G Wing, Hamilton, Ontario, L8V 1C3, Canada; Program in Evidence-based Care, Cancer Care Ontario McMaster University, Juravinski Site, 60 (G) Wing, 711 Concession Street Hamilton, Ontario, Canada, L8V 1C3.
authors.forename: Hans
authors.initials: H
authors.lastname: Messersmith
authors.affiliation: Department of Oncology, McMaster University, 1280 Main Street West Hamilton, Ontario L8S4L8, Canada; Escarpment Cancer Research Institute (ECRI), Juravinski Hospital Research Centre, 711 Concession Street, G Wing, Hamilton, Ontario, L8V 1C3, Canada; Program in Evidence-based Care, Cancer Care Ontario McMaster University, Juravinski Site, 60 (G) Wing, 711 Concession Street Hamilton, Ontario, Canada, L8V 1C3.
authors.forename: Sheila
authors.initials: S
authors.lastname: McNair
authors.affiliation: Department of Oncology, McMaster University, 1280 Main Street West Hamilton, Ontario L8S4L8, Canada; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West Hamilton, Ontario L8S4L8, Canada; Escarpment Cancer Research Institute (ECRI), Juravinski Hospital Research Centre, 711 Concession Street, G Wing, Hamilton, Ontario, L8V 1C3, Canada; Program in Evidence-based Care, Cancer Care Ontario McMaster University, Juravinski Site, 60 (G) Wing, 711 Concession Street Hamilton, Ontario, Canada, L8V 1C3. Electronic address: mbrouwer@mcmaster.ca.
authors.forename: Melissa
authors.initials: M
authors.lastname: Brouwers
mesh_terms: D055317:Evidence-Based Practice; D006292:Health Priorities; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*
keywords: Clinical practice guidelines (CPGs); Evidence-based guidelines; Guideline assessment; Guideline review methodology; Guideline update; Prioritization