Abstract
While it is important for the evidence supporting practice guidelines to be current,
that is often not the case. The advent of living systematic reviews has made the concept
of “living guidelines” realistic, with the promise to provide timely, up-to-date and
high-quality guidance to target users. We define living guidelines as an optimization
of the guideline development process to allow updating individual recommendations
as soon as new relevant evidence becomes available. A major implication of that definition
is that the unit of update is the individual recommendation and not the whole guideline.
We then discuss when living guidelines are appropriate, the workflows required to
support them, the collaboration between living systematic reviews and living guideline
teams, the thresholds for changing recommendations, and potential approaches to publication
and dissemination. The success and sustainability of the concept of living guideline
will depend on those of its major pillar, the living systematic review. We conclude
that guideline developers should both experiment with and research the process of
living guidelines.
Keywords
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Article info
Publication history
Published online: September 10, 2017
Accepted:
August 17,
2017
Footnotes
Conflicts of interest: The authors declare no financial conflict of interest. They are all interested in the field of living guidelines and involved in projects to develop living guidelines.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
