B CASHMORE 1,2, D TUNNICLIFFE 1,2
1 Sydney School of Public Health, The University of Sydney, Sydney, Australia, 22. Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
Aim: To describe the methods and to transform and produce living guidelines on chronic kidney disease.
Background: Evidence synthesis translates scientific literature to inform guidelines. The traditional processes used for guideline development are rigorous but are resource-intensive. The rapidly expanding medical literature has meant that guidelines are not able to keep up to date. Resulting in clinical decision-making that does not reflect the entirety of the evidence. To overcome these challenges “Living Guidelines” have been proposed.
Methods: CARI Guidelines partnered with Cochrane Kidney and Transplant to develop living guidelines. A guideline on cholesterol-lowering therapy for people with chronic kidney disease was identified as a pilot living guideline. A Cochrane systematic review on HMG-CoA reductase inhibitors was updated to provide the underlying evidence review for the guideline. A guideline Work Group with relevant clinical expertise, lived experience, and methodological knowledge was convened to develop guidelines according to international best practice.
Results: The Cochrane systematic review was updated in 20 days. The Work Group included multidisciplinary expertise, including consumers, cardiologists, nephrologists, general practitioners, and Indigenous Health experts. The guideline Work Group meet on the 26th of August 2020 to discuss the findings of the evidence review and draft guideline recommendations. Two more subsequent meetings with the Work Group and within 4 months the guidelines were published. Ongoing evidence surveillance is occurring and guidelines will be updated when new and important evidence emerges
Conclusion: Living guidelines provide the most up-to-date recommendations to support clinical decision-making and addressing topics and outcomes that are relevant and important to the kidney community. Overall, the production of living guidelines is feasible and will be used to transform guidelines in kidney disease.
Brydee Cashmore is a Researcher for Caring for Australian and New Zealanders with Kidney Impairment (CARI) Guidelines, at the Centre for Kidney Research, the University of Sydney.