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close this bookDeveloping HIV/AIDS Treatment Guidelines (UNAIDS, 1999, 43 p.)
View the document(introduction...)
View the documentAcknowledgement
View the documentHow to use this booklet
Open this folder and view contentsPart 1: Appraisal and validation of existing guidelines
Open this folder and view contentsPart 2: Developing valid HIV/AIDS guidelines
View the documentAppendix: Guideline appraisal tools
View the documentAnnotated bibliography
View the documentBack cover

Appendix: Guideline appraisal tools

Part one: Criteria for appraisal of validity of the guidelines development process

Responsibility and support for guideline development




1. Does the guideline report identify the agencies responsible for its development and ratification?

2. Were potential biases or conflicts of interest in funding or support agencies satisfactorily taken into account?

Guideline development committee membership

3. Is there a list of the individuals who were involved in developing the guidelines and their professional background or affiliation (e.g. medical, guideline development experts, interest groups including patients)?

4. Did the committee have representatives with experience in HIV/AIDS clinical care and guideline development?

5. Did the committee include patients or their representatives?

6. Were potential biases or conflicts of interest among members satisfactorily taken into account?

Identification and synthesis of evidence

7. Is there a description of the method(s) used to collect (i.e. identify and retrieve) the scientific evidence on which recommendations are based?

8. Are the methods for collecting scientific evidence satisfactory?

9. Are the sources of information used in developing recommendations adequately referenced?

10. Is there a description of the methods used to seek the views of interest groups not on the guideline development committee?

Strength of scientific evidence

11. Is there a description of the methods used to assess the strength of scientific evidence?

12. Does the guideline make explicit links between recommendations and the strength of the supporting scientific evidence?

13. Overall, are the methods used to rate or weigh the scientific evidence satisfactory?

Pre-testing and peer review

14. Was the guideline subjected to independent peer review by experts outside the committee?

15. Was the guideline piloted or pre-tested?

16. If the guideline was piloted or pre-tested, does it report the methods used and the results adopted?

Future review and revision

17. Does the guideline give explicit details of how it will be routinely reviewed?

18. Does the guideline identify which bodies are responsible for the review?

19. Is a review form provided for users to send in their comments?

Overall assessment of validity of the guideline development

20. Is there, in the guideline development report, an accurate summary that reflects the methods, content and recommendations?

21. Overall, do the potential biases or conflicts of the guideline s development appear to be adequately dealt with?

Part two: Criteria for appraisal of the content and format of the guideline

Clinical applicability and flexibility




1. Was the patient population(s) identified to which the guideline is meant to apply?

2. Is there a description of the professional groups to which the guideline is meant to apply?

3. Does the guideline indicate at what level of care it is to be used?

4. Is there a description of the circumstances (clinical or non-clinical) in which exceptions might be made in using it?

5. Is there a description of ethical issues likely to rise in using the guideline?

6. Is there a description of how the patients preferences should be taken into account in applying the guidelines?

7. Do the recommendations collectively cover all clinically relevant circumstances(including diagnostic process, clinical management and referral)?

8. Are the guideline recommendations consistent with each other?


9. Are the main recommendations presented in a format that is easily understandable (statements, algorithms, or diagrams)?

10. Does the guideline describe in explicit terms the condition to be detected, treated or prevented?

11. Does the guideline describe in explicit terms the options for management of the condition?

12. Does the guideline identify and advise on unacceptable or ineffective current practice?

13. Are the recommendations written in unequivocal terms?

14. Can each major recommendation be found easily?

Description of likely costs and benefits

15. Is there an adequate description of the health benefits expected from the recommended clinical management?

16. Is there a description of the potential harm or risk that may occur as a result of specific clinical management?

17. Is there an adequate description of the costs or expenditure expected in a specific clinical management?

18. Are issues for consideration by managers in health boards and trusts/ practices clearly identified?

19. Are the recommendations supported by the estimated benefits, possible harm and costs?

Clinical audit

20. Does the guideline identify key clinical outcomes for the areas of care covered?

21. Are targets or standards identified?

22. Does the guideline identify the core clinical data for reporting the relevant clinical care?

23. Do the core clinical data include key indicators of risk and severity?

*N/A: Not applicable