I have just completed the development of a guideline for children presenting with acute breathing difficulties (awaiting peer review).
The guideline was devleoped by a very rigorous methodology.
1.review of the literature including hand searched and looking for unpublished data.
2.Search for existing guidelines
3.grading of literature where evidence is available.
4.In paediatrics there is often very little literature or studies that are not rct's but extremely important. We therefore used the Delphi consensus process (multidisciplinary team approach) with 50 members of the panel to develop consensus where evidence was lacking but also as an internal peer review of the literature that had been appraised. All members of the panel received the literature and the grade given and they could therefore check these but they could also provide their own opinion of the wording used in the recommendation and check that nothing had been imitted in the process. This process also allowed us to see how clinicians wieghted particular recommendations despite the evidence grade tehy had been given. We aso a patient leaflet to the Delphi panellists for their suggestions on how it could be improved.
i am interested in people's thought s about what we have done because I cannot not find anyone else who has used this combination of methods to produce a guideline, but I would also be interested to know if there is any journal that would be interested in the publication of not only the guideline (because this would probably go to a resp /paed journal) but the methodology of development.