Our guideline scoring system is nearly a year old and it’s been well received by all types of Trip users. Over time we add new guideline producers and these scores are added to the system.

We are in the process of adding ten new guidelines producers and it’s really disappointing to see most of them scoring really low! As a reminder this is how we score guidelines (at the publisher level, not individual guideline level):

  • Do they publish their methodology? No = 0, Yes = 1, Yes and mention AGREE (or similar) = 2
  • Do they use any evidence grading e.g. GRADE? No = 0, Yes = 2
  • Do they undertake a systematic evidence search? Unsure/No = 0, Yes = 2
  • Are they clear about funding? No = 0, Yes = 1
  • Do they mention how they handle conflict of interest? No = 0, Yes = 1

Of the ten new publishers we could find no information on their methodology, most didn’t use GRADE and we have no idea about the search. Funding is most frequently mentioned and their is no way of knowing how they deal with conflict of interest. A number highlight potential conflicts but not how this is managed – in which case the publisher gets a zero score for that element.

It does make me wonder how users of the guidelines feel? I think the answer is, and this is a worry, that many won’t care or consider the implications. How can you be confident that the guideline you’re using has been produced in an unbiased manner? In short the answer has to be faith, faith in the publishing organisation. This authority bias is problematic for many reasons.

In short, guideline publishers, please be more transparent with your processes, it shouldn’t be difficult…!