Knowledge exchange seminar series – Session on induction of topic expert committee members in guideline development

A second knowledge exchange seminar series was organized as a part of the collaborative project between the National Institute for Health and Care Excellence (NICE) International and Indian Health Outcomes, Public Health and Economics Research Centre (IHOPE) to develop and implement evidence-based clinical guidelines in India. This paper is the sixth in the second series of this collaboration, and further information on the other papers can be found at https://ihopejournalofophthalmology.com/issue/2022-1-2.

Guidelines are a set of rules or recommendations to aid in decision-making. In healthcare, guidelines are evidence-based recommendations for clinical practice, social care, and public health policy or services. These guidelines and recommendations are developed to help end-users, including healthcare professionals, patients, and carers, make informed decisions on specific issues such as medical interventions, diagnostic tests, or undertaking public health or social care measures to achieve the best healthcare outcomes for the patients or population.^[1] National and state-level agencies can develop the guidelines; for instance, the Ministry of Health and Family Welfare sets standard treatment guidelines for various clinical conditions in India. Similarly, around the world, different organizations develop clinical guidelines; for instance, the World Health Organization develops global guidelines, the National Institute for Health and Care Excellence in the UK, the Agency for Healthcare Research and Quality in the US, and so on. Members of the topic expert committee are appointed for a duration of 3 years or the entirety of the guideline development process and are required to attend all meetings.

Guideline committees include a diverse range of people from different sectors and professions who develop the guidelines and recommendations;^[2] therefore, recruiting, forming, and convening a topic expert committee is one of the most important stages in the guideline development process. Members of the topic expert committee are appointed for a duration of 3 years or the entirety of the guideline development process and are required to attend all meetings. Furthermore, as committee members come with different knowledge and experience, facilitating a common understanding of the guideline development process ensures that all committee members are able to contribute fully throughout the process, other content to cover the methods to be followed, the committee terms of reference, and the role and responsibilities of each member.

The first step is preparing the agenda for the induction session outlining the key roles and processes that the committee needs to be aware of. Different people in the Secretariat deliver each agenda item; for example, the project manager and administrator will discuss their roles, the technical team will discuss details about the methods to be followed, and the committee members will outline their areas of expertise and experience. It is useful to have detailed documents for committee members to refer to and read before the induction session. The essential points to be covered in the induction documentation and session include:

1. Introducing key people in the secretariat: During the introductions, each member of the committee introduces themselves and their background. Next, the secretariat members, guideline methodologists, health economists and project managers introduce themselves and their roles. This introduction helps establish the link between the secretariat and committee members. It also clarifies for the committee who is responsible for different aspects of guideline development and, importantly, who is the main contact person for the committee. The guideline development process is very interactive, with frequent communication between the secretariat and the committee.

2. Outlining the key stages in the guideline development: This involves understanding how the guideline scope or remit was developed and the importance of staying within the agreed limits; the timeline for systematic reviews and health economic models, the inputs into decision making; how evidence will be interpreted and considered; and the role of public consultation. All the members are advised to refer to the methods manual before the induction meeting.

3. Managing expectations: It is important to outline what is expected of the committee members, such as maintaining confidentiality, reading the meeting papers in advance, attending all the committee meetings, responding to the queries from the secretariat, and contributing positively during the committee meetings and adhering to the timeline on commenting and drafting the documents. It is also crucial to outline what that committee can expect of the secretariat in terms of information in advance of each meeting and prompt responses to queries.

4. Outlining the objective of the committee meeting: Most of the committee meetings involve discussion of evidence or stakeholder comments, and drafting recommendations. Therefore, it is essential to clarify what committee members should consider and to be prepared to be challenged by the evidence and each other and to compromise if necessary. Committee members should examine the evidence in light of their experience and expertise to assess the generalizability of the evidence base and its applicability in the specific context.

5. Methods to be used: Once the roles have been outlined, it is crucial to focus on the methods to be used when assessing the evidence; this involves outlining the evidence reviewing process, from review protocol to specific methodologies, and how the evidence will be presented to the committee. It should also cover the essentials of the types of questions, evidence types such as qualitative or quantitative evidence, and how evidence will be presented, such as forest plots, summary tables, and evidence tables.

6. Processes and timelines: The committee should be kept up to date with the key deadlines and timelines of the project. The secretariat should ensure that members have enough time to read the meeting papers and to consider their input in advance of each committee meeting. Typically, sending out meeting papers a week in advance gives the committee sufficient time to respond to any queries or to consider their input.

7. Implementation: An aspect of the committee member’s role is to support the implementation of the guideline, so it is an excellent opportunity to outline and discuss the barriers and facilitators to implementation.